Comparison of thoracic epidural analgesia method and intravenous PCA (Patient Controlled Analgesia) in terms of analgesia and surgical complications in patients with upper abdominal surgery

Prevention and treatment of acute postoperative pain have an important role in improvement of patients’ conditions. This study aimed to compare between two methods (IV- patient controlled analgesia and Thoracic Epidural Analgesia) in terms of analgesia and surgical complications in patients with upper abdominal surgery.

In this clinical trial study, the subjects were chosen from the patients referred to Besat hospital in Hamadan for upper abdominal surgery. Sample size in each group was 72 patients. Data was collected by a questionnaire that included assessment of pulmonary function, pain levels (in both quantitative and qualitative scales), postoperative complications, analgesic usage, and patient satisfaction. After all data was analyzed by SPSS V: 21.

Postoperative pain during the first 24 hours after surgery was higher in epidural group by using quantitative and qualitative methods but in second 24 hours, pain in this group only by qualitative method was more (Which was statistically meaningful). Complications of analgesic techniques were similar in both groups, but nausea in the PCA group and paresthesia in the epidural group was higher. The respiratory parameters measured didn't show significant differences between two methods. Patient satisfaction was greater in the PCA group but there are no differences between groups in satisfaction of nurses.

The PCA method is effective as the thoracic epidural analgesia method in reducing post-operative pain, and since this method is simpler and less expensive, it can be used safely for post-operative analgesia. Also it's better not to use a thoracic epidural method in patients with spinal, neuromuscular and sensory disorders.