Clinical Experience of Postoperative Pain Control

Abstract

Background : We prospectively studied 615 patients who received postoperative pain control (epidural analgesia or intravenous patient controlled analgesia) to evaluate pain relief, side effects and complications. Methods : All study patients receiving postoperative pain control were assessed three times a day by the pain control resident for pain relief, using a visual analogue scale. The presence of side effects and complications was assessed. Results : Over 1year, 615 patients (65.9% women, aged 46.9±16.4yr) were studied. General surgery, gynecology and obstetrics in the department; and lower abdomen, upper abdomen and perineum in the operation site were order of decreasing frequency. The most common site of epidural puncture level was T12-L1 in the epidural analgesia. The average pain score using VAS in all groups was less than 3.0 and the degree of satisfaction in postoperative pain control was rated as good on 88% of the patients. Nausea occurred in 9.1% of all patients, vomiting in 6.3%, pruritis in 0.9%, urinary retention in 2.6%, hypotension in 3.2%, but there was no case of respiratory depression. Dislodgement of the epidural catheter occurred in 0.5% of all patients. Conclusions : Postoperative epidural fentanyl/bupivacaine infusions and IV PCA are an effective method of postoperative pain control with a low incidence of side effects. We believe that, with appropriate patient observations and careful drug selection and with the use of epidural catheters placed appropriately for the proposed surgery, that high quality postoperative pain control can be offered. (Korean J Anesthesiol 1997; 32: 281∼288)