Epidural vs patient-controlled analgesia for postoperative pain after pectus excavatum repair: a prospective, randomized trial.

Creator(s)

Shawn D. St Peter, Children's Mercy HospitalFollow
Kathryn A. Weesner, Children's Mercy HospitalFollow
Eric E. Weissend, Children's Mercy HospitalFollow
Susan W. Sharp
Patricia A. Valusek
Ronald J. Sharp
Charles L. Snyder, Children's Mercy HospitalFollow
G W. Holcomb III, Children's Mercy HospitalFollow
Daniel J. Ostlie

Document Type

Article

Publication Date

1-1-2012

Identifier

DOI: 10.1016/j.jpedsurg.2011.10.040

Abstract

PURPOSE: Management of postoperative pain is a challenge after the minimally invasive repair of pectus excavatum. Pain is usually managed by either a thoracic epidural or patient-controlled analgesia with intravenous narcotics. We conducted a prospective, randomized trial to evaluate the relative merits of these 2 pain management strategies.

METHODS: After obtaining permission/assent (Institutional Review Board no. 06 08 128), patients were randomized to either epidural or patient-controlled analgesia with fixed protocols for each arm. The primary outcome variable was length of stay with a power of .8 and α of .05.

RESULTS: One hundred ten patients were enrolled. There was no difference in length of stay between the 2 arms. A longer operative time, more calls to anesthesia, and greater hospital charges were found in the epidural group. Pain scores favored epidural for the few days and favored patient-controlled analgesia thereafter. The epidural catheter could not be placed or was removed within 24 hours in 12 patients (22%).

CONCLUSIONS: There is longer operating room time, increase in calls to anesthesia, and greater hospital charges with epidural analgesia after repair of pectus excavatum. Pain scores favor the epidural approach early in the postoperative course and patient-controlled analgesia later.

Journal Title

Journal of pediatric surgery

Volume

47

Issue

1

First Page

148

Last Page

153

MeSH Keywords

Adolescent; Analgesia, Epidural; Analgesia, Patient-Controlled; Funnel Chest; Humans; Pain, Postoperative; Prospective Studies

Keywords

Pain management; Postoperative pain

Recommended Citation

St Peter, S. D., Weesner, K. A., Weissend, E. E., Sharp, S. W., Valusek, P. A., Sharp, R. J., Snyder, C. L., Holcomb, G. W., Ostlie, D. J. Epidural vs patient-controlled analgesia for postoperative pain after pectus excavatum repair: a prospective, randomized trial. Journal of pediatric surgery 47, 148-153 (2012).