Epidural analgesia with low-concentration levobupivacaine combined with fentanyl provides satisfactory postoperative analgesia for colorectal surgery patients

Mei Chi Lin, Jui Yu Huang, Hsuan Chih Lao, Pei-Shan Tsai, Chun Jen Huang

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Epidural patient-controlled analgesia (EPCA) with a mixture of low-concentration levobupivacaine (0.0625 or 0.1) plus fentanyl, with basal infusion, has been extensively used for postoperative analgesia in our allied institutions. To elucidate whether these two EPCA regimens provide satisfactory analgesia, we compared the analgesia efficacy and incidence of drug-related side effects for both EPCA regimens with those of the most widely used postoperative analgesia regimen, intra-venous PCA (IVPCA) with morphine. Data collection was performed through retrospective chart review. A total of 335 patients who underwent colorectal surgery were included. Patients received IVPCA (n = 200), EPCA with 0.0625 levobupivacaine/fentanyl (n = 45), or EPCA with 0.1 levobupivacaine/fentanyl (n = 90). The analgesia efficacy and side effects were compared. Pain scores with 0.0625 and 0.1 EPCA were significantly lower than those with IVPCA. Most patients were satisfied with their postoperative analgesia, and the satisfaction scores of these three groups were comparable. No patients developed respiratory depression or over-sedation. The incidence of nausea and vomiting was significantly higher with 0.1 EPCA (16.7 and 7.8, respectively) compared with IVPCA (6.1 and 3.5, respectively) and 0.0625 EPCA (9.3 and 2.3, respectively). Moreover, the incidence of sensory and motor blockade was significantly higher with 0.1 EPCA (13.5 and 5.6, respectively) than with 0.0625 EPCA (4.7 and 0, respectively). Epidural analgesia with low-concentration levobupivacaine plus fentanyl provides satisfactory postoperative analgesia with few side effects for patients after colorectal surgery.

Original languageEnglish
Pages (from-to)68-74
Number of pages7
JournalActa Anaesthesiologica Taiwanica
Volume48
Issue number2
DOIs
Publication statusPublished - Jun 2010

Fingerprint

Colorectal Surgery
Epidural Analgesia
Patient-Controlled Analgesia
Fentanyl
Analgesia
Passive Cutaneous Anaphylaxis
Incidence
levobupivacaine
Drug-Related Side Effects and Adverse Reactions
Respiratory Insufficiency
Morphine
Nausea
Vomiting

Keywords

  • colorectal surgery
  • epidural analgesia
  • fentanyl
  • levobupivacaine
  • patient-controlled analgesia

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Epidural analgesia with low-concentration levobupivacaine combined with fentanyl provides satisfactory postoperative analgesia for colorectal surgery patients. / Lin, Mei Chi; Huang, Jui Yu; Lao, Hsuan Chih; Tsai, Pei-Shan; Huang, Chun Jen.

In: Acta Anaesthesiologica Taiwanica, Vol. 48, No. 2, 06.2010, p. 68-74.

Research output: Contribution to journalArticle

@article{ef3374080d6b445f9a82e26f8931a1c2,
title = "Epidural analgesia with low-concentration levobupivacaine combined with fentanyl provides satisfactory postoperative analgesia for colorectal surgery patients",
abstract = "Epidural patient-controlled analgesia (EPCA) with a mixture of low-concentration levobupivacaine (0.0625 or 0.1) plus fentanyl, with basal infusion, has been extensively used for postoperative analgesia in our allied institutions. To elucidate whether these two EPCA regimens provide satisfactory analgesia, we compared the analgesia efficacy and incidence of drug-related side effects for both EPCA regimens with those of the most widely used postoperative analgesia regimen, intra-venous PCA (IVPCA) with morphine. Data collection was performed through retrospective chart review. A total of 335 patients who underwent colorectal surgery were included. Patients received IVPCA (n = 200), EPCA with 0.0625 levobupivacaine/fentanyl (n = 45), or EPCA with 0.1 levobupivacaine/fentanyl (n = 90). The analgesia efficacy and side effects were compared. Pain scores with 0.0625 and 0.1 EPCA were significantly lower than those with IVPCA. Most patients were satisfied with their postoperative analgesia, and the satisfaction scores of these three groups were comparable. No patients developed respiratory depression or over-sedation. The incidence of nausea and vomiting was significantly higher with 0.1 EPCA (16.7 and 7.8, respectively) compared with IVPCA (6.1 and 3.5, respectively) and 0.0625 EPCA (9.3 and 2.3, respectively). Moreover, the incidence of sensory and motor blockade was significantly higher with 0.1 EPCA (13.5 and 5.6, respectively) than with 0.0625 EPCA (4.7 and 0, respectively). Epidural analgesia with low-concentration levobupivacaine plus fentanyl provides satisfactory postoperative analgesia with few side effects for patients after colorectal surgery.",
keywords = "colorectal surgery, epidural analgesia, fentanyl, levobupivacaine, patient-controlled analgesia",
author = "Lin, {Mei Chi} and Huang, {Jui Yu} and Lao, {Hsuan Chih} and Pei-Shan Tsai and Huang, {Chun Jen}",
year = "2010",
month = "6",
doi = "10.1016/S1875-4597(10)60016-1",
language = "English",
volume = "48",
pages = "68--74",
journal = "Asian Journal of Anesthesiology",
issn = "2468-824X",
publisher = "Elsevier Taiwan LLC",
number = "2",

}

TY - JOUR

T1 - Epidural analgesia with low-concentration levobupivacaine combined with fentanyl provides satisfactory postoperative analgesia for colorectal surgery patients

AU - Lin, Mei Chi

AU - Huang, Jui Yu

AU - Lao, Hsuan Chih

AU - Tsai, Pei-Shan

AU - Huang, Chun Jen

PY - 2010/6

Y1 - 2010/6

N2 - Epidural patient-controlled analgesia (EPCA) with a mixture of low-concentration levobupivacaine (0.0625 or 0.1) plus fentanyl, with basal infusion, has been extensively used for postoperative analgesia in our allied institutions. To elucidate whether these two EPCA regimens provide satisfactory analgesia, we compared the analgesia efficacy and incidence of drug-related side effects for both EPCA regimens with those of the most widely used postoperative analgesia regimen, intra-venous PCA (IVPCA) with morphine. Data collection was performed through retrospective chart review. A total of 335 patients who underwent colorectal surgery were included. Patients received IVPCA (n = 200), EPCA with 0.0625 levobupivacaine/fentanyl (n = 45), or EPCA with 0.1 levobupivacaine/fentanyl (n = 90). The analgesia efficacy and side effects were compared. Pain scores with 0.0625 and 0.1 EPCA were significantly lower than those with IVPCA. Most patients were satisfied with their postoperative analgesia, and the satisfaction scores of these three groups were comparable. No patients developed respiratory depression or over-sedation. The incidence of nausea and vomiting was significantly higher with 0.1 EPCA (16.7 and 7.8, respectively) compared with IVPCA (6.1 and 3.5, respectively) and 0.0625 EPCA (9.3 and 2.3, respectively). Moreover, the incidence of sensory and motor blockade was significantly higher with 0.1 EPCA (13.5 and 5.6, respectively) than with 0.0625 EPCA (4.7 and 0, respectively). Epidural analgesia with low-concentration levobupivacaine plus fentanyl provides satisfactory postoperative analgesia with few side effects for patients after colorectal surgery.

AB - Epidural patient-controlled analgesia (EPCA) with a mixture of low-concentration levobupivacaine (0.0625 or 0.1) plus fentanyl, with basal infusion, has been extensively used for postoperative analgesia in our allied institutions. To elucidate whether these two EPCA regimens provide satisfactory analgesia, we compared the analgesia efficacy and incidence of drug-related side effects for both EPCA regimens with those of the most widely used postoperative analgesia regimen, intra-venous PCA (IVPCA) with morphine. Data collection was performed through retrospective chart review. A total of 335 patients who underwent colorectal surgery were included. Patients received IVPCA (n = 200), EPCA with 0.0625 levobupivacaine/fentanyl (n = 45), or EPCA with 0.1 levobupivacaine/fentanyl (n = 90). The analgesia efficacy and side effects were compared. Pain scores with 0.0625 and 0.1 EPCA were significantly lower than those with IVPCA. Most patients were satisfied with their postoperative analgesia, and the satisfaction scores of these three groups were comparable. No patients developed respiratory depression or over-sedation. The incidence of nausea and vomiting was significantly higher with 0.1 EPCA (16.7 and 7.8, respectively) compared with IVPCA (6.1 and 3.5, respectively) and 0.0625 EPCA (9.3 and 2.3, respectively). Moreover, the incidence of sensory and motor blockade was significantly higher with 0.1 EPCA (13.5 and 5.6, respectively) than with 0.0625 EPCA (4.7 and 0, respectively). Epidural analgesia with low-concentration levobupivacaine plus fentanyl provides satisfactory postoperative analgesia with few side effects for patients after colorectal surgery.

KW - colorectal surgery

KW - epidural analgesia

KW - fentanyl

KW - levobupivacaine

KW - patient-controlled analgesia

UR - http://www.scopus.com/inward/record.url?scp=77956635660&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77956635660&partnerID=8YFLogxK

U2 - 10.1016/S1875-4597(10)60016-1

DO - 10.1016/S1875-4597(10)60016-1

M3 - Article

VL - 48

SP - 68

EP - 74

JO - Asian Journal of Anesthesiology

JF - Asian Journal of Anesthesiology

SN - 2468-824X

IS - 2

ER -