Patient−controlled epidural analgesia: a nursing perspective

Abstract

This article discusses the use of patient−controlled epidural analgesia (PCEA) for patients undergoing gastrointestinal surgery, from a nursing perspective. Despite progress in postoperative pain relief over the last decade, a number of patients experience severe pain after major surgery, which can include gastrointestinal surgery. Optimal postoperative pain relief needs to be further improved as it is not only about sensation management, but the whole person. Numerous studies have indicated that patient−controlled analgesia is generally an effective method of delivering postoperative analgesia, but more safety considerations are highlighted for PCEA. However, the literature suggests that these safety issues can be effectively managed with specific nurse and patient education programmes. Thus, the article addresses PCEA as a potentially useful post−surgical analgesic technique for gastrointestinal surgery that is not commonly used in the UK. The three issues discussed, as related to nursing, are efficacy, safety and the nursing implications in the management of PCEA.