Comparing Epidural Analgesia and ON-Q Infiltrating Catheters for Pain Management after Hepatic Resection  

作　　者：Jose M. Soliz Rodolfo Gebhardt Lei Feng Wenli Dong Margaret Reich Steven Curley 

机构地区：[1]The University of Texas Health Science Center, San Antonio Medical School, San Antonio, USA [2]The University of Texas MD Anderson Cancer Center, Houston, USA

出　　处：《Open Journal of Anesthesiology》2013年第1期3-7,共5页麻醉学期刊（英文）

摘　　要：Background and Objectives: Pain control after hepatic resection presents unique challenges as subcostal incisions, rib retraction, and diaphragmatic irritation can lead to significant pain. Both epidural analgesia and ON-Q catheters have been used for postoperative pain management after hepatic surgery, but to our knowledge have not been directly compared. Methods: The records of 143 patient between the ages 18 and 70 were reviewed who underwent hepatic resection by a single surgeon. Patients were categorized according to method of postoperative pain control. Average pain scores for both study groups were collected until POD#3. Results: Demographic data and the length of surgery were similar between the groups (all P > 0.05). On the day of surgery and POD#1, average pain scores for the epidural group were lower than the ON-Q group (P 0.0001 and P = 0.0008 respectively). There was no difference in pain scores on POD #2 (P = 0.2369) or POD #3 (P = 0.2289). Conclusions: Epidural analgesia provides superior pain control on the day of surgery and POD#1 when compared to On-Q catheter with IV PCA. There was no difference in pain scores on POD#2 or POD#3. Future prospective randomized trials comparing these analgesic methods will be required to further evaluate enhanced recovery after hepatic surgery.Background and Objectives: Pain control after hepatic resection presents unique challenges as subcostal incisions, rib retraction, and diaphragmatic irritation can lead to significant pain. Both epidural analgesia and ON-Q catheters have been used for postoperative pain management after hepatic surgery, but to our knowledge have not been directly compared. Methods: The records of 143 patient between the ages 18 and 70 were reviewed who underwent hepatic resection by a single surgeon. Patients were categorized according to method of postoperative pain control. Average pain scores for both study groups were collected until POD#3. Results: Demographic data and the length of surgery were similar between the groups (all P > 0.05). On the day of surgery and POD#1, average pain scores for the epidural group were lower than the ON-Q group (P 0.0001 and P = 0.0008 respectively). There was no difference in pain scores on POD #2 (P = 0.2369) or POD #3 (P = 0.2289). Conclusions: Epidural analgesia provides superior pain control on the day of surgery and POD#1 when compared to On-Q catheter with IV PCA. There was no difference in pain scores on POD#2 or POD#3. Future prospective randomized trials comparing these analgesic methods will be required to further evaluate enhanced recovery after hepatic surgery.

关 键 词：Hepatic Resection EPIDURAL On-Q CATHETER Postoperative Pain Control 

分 类 号：R73[医药卫生—肿瘤]