Comparison of epidural and intravenous route for acute and chronic postoperative pain control in patients with gynecological malignancy
Bedih Balkan1
, Gokhan Demirayak2, Halil Çetingök3, Cihan Comba2, Yusuf Ziya Yener1, Gülsüm Oya Hergünsel1, İsa Aykut Özdemir2
1Department of Anesthesiology and Reanimation, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
2Department of Gynecologic Oncology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
3Division of Algology, Department of Anesthesiology and Reanimation, İstanbul University Faculty of Medicine, İstanbul, Turkey
Keywords: Acute postoperative pain, chronic postoperative pain; epidural patient-controlled analgesia; gynecologic malignancy; intravenous patient-controlled analgesia.
Abstract
Objectives: This study compared the effects of patient-controlled epidural and intravenous analgesia on acute and chronic postoperative pain in patients who were operated on for gynecological malignancy.
Methods: Postoperatively, patient-controlled analgesia was administered via epidural route to Group 1 and the intravenous route to Group 2. Pain was evaluated using the Visual Analog Scale (VAS) in the acute phase at postoperative 24 hours and at 6 months in the chronic phase.
Results: The VAS scores at 24 hours were lower in Group 1 than in Group 2 (3.29 vs 3.93; p<0.05). The VAS scores at 6 months were 2.03 in Group 1 and 2.53 in Group 2, indicating no statistically significant difference (p>0.05). There was no significant difference in the Leeds Assessment of Neuropathic Symptoms and Signs pain scale scores at 6 months (p>0.05).
Conclusion: The results showed that epidural and intravenous analgesia had a similar effect regarding the chronicity of pain but better outcomes were achieved with epidural analgesia in the acute stage.