Safety and efficacy of patient controlled epidural analgesia versus conventional epidural analgesia in lower limb orthopedic surgeries: a prospective randomized study

Abstract

Background Orthopedic surgeries lead to moderate to severe postoperative pain, treating which is a challenge to the anesthesiologist. The present prospective, randomized study was carried out to compare the efficacy of postoperative pain relief between patient controlled epidural analgesia (PCEA) and conventional intermittent bolus epidural analgesia (IBEA) \with very low concentration of bupivacaine plus fentanyl in 60 ASA I and ASA II patients for orthopedic lower limb surgeries. Following variables like heart rate, mean arterial pressure, oxygen saturation, visual analogue scale (VAS) score, total analgesic consumption, patient satisfaction (Likert scale) and side effects were assessed for 24 h postoperatively. Results The hemodynamic parameters were comparable in both the groups at various time intervals. There was a significant decrease in VAS score, less analgesic consumption, less rescue analgesia requirement and more patient satisfaction in PCEA group as compared to IBEA group. Conclusions Patient controlled epidural analgesia (PCEA) with a combination of bupivacaine and fentanyl has more efficacy and safety than intermittent bolus epidural analgesia (IBEA) so it should be used more often.