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.
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