Comparison Between Two Methods of Patient-Controlled Analgesia Through Intravenous and Thoracic Epidural to Control Pain and Complications After Surgery in Esophageal Cancer Patients: A Randomized Controlled Trial

Maziar Maghsoudloo; Sina Abbassi; Shahram Samadi; Mohammad Taghi Beigmohammadi; Asghar Hajipour; Mahboubeh Atashgahi; Siavash Abbassi; Fariba Badrzadeh; Omid Nabavian

doi:10.18502/acta.v61i6.13833

Maziar Maghsoudloo Department of Anesthesiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Sina Abbassi Department of Anesthesiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Shahram Samadi Department of Anesthesiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Taghi Beigmohammadi Department of Intensive Care, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Asghar Hajipour Department of Anesthesiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Mahboubeh Atashgahi Department of Anesthesiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Siavash Abbassi Faculty of Medicine, Golestan University of Medical Sciences, Golestan, Iran
Fariba Badrzadeh Faculty of Medicine, Golestan University of Medical Sciences, Golestan, Iran
Omid Nabavian Department of Anesthesiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/acta.v61i6.13833

Keywords: Esophageal carcinoma; Patient-controlled epidural analgesia; Patient-controlled intravenous analgesia

Abstract

The aim of this study was to compare the post-operation analgesic effects of patient-controlled epidural analgesia and patient-controlled intravenous analgesia for patients who were undergoing esophageal cancer surgery. This was a randomized clinical trial. 80 patients undergone esophagostomy were randomly divided into two groups: 40 patients in the epidural PCA and 40 patients in the intravenous PCA group were evaluated. Post-operation pain score was assessed using the universal pain assessment tool (UPAT) in both groups at 24 and 48 hours after surgery. Secondary outcomes included AKI, MI, CVA, pulmonary complications, ICU stay and three months survival. Mean pain scores were similar in the two groups (P>0.05). There was no significant difference between the two groups for rescue treatment, three months’ survival, CVA, MI and AKI. However, ICU stay (P=0.008) and pulmonary complications (P=0.05) were greater in PCIA group. The results indicate that none of the PCEA and PCIA methods have any superiority in terms of pain control and the incidence of analgesic-related side effect complications after surgery in patients undergoing esophagostomy and confirm sufficient analgesia by both.