Table 4.
Postoperative analgesia in patients undergoing major hepatectomy in the present series
| Epidural group (n = 69) | CIB + PCA group (n = 429) | P-value | |
|---|---|---|---|
| Time to discontinuation, days, median (range) | 3 (1–5) | 4 (1–8) | 0.001 |
| Cumulative opioid consumptiona, mg, median (range) | |||
| 12 h | 29.1 (0.0–266.0) | 17.5 (0.0–1015.0) | < 0.001 |
| 24 h | 91.2 (5.0–1546.4) | 43.0 (0.0–1225.0) | <0.001 |
| 48 h | 148.4 (6.0–1952.8) | 58.0 (0.0–1625.0) | <0.001 |
| 72 h | 186.1 (4.0–1952.8) | 61.0 (0.0–1650.0) | <0.001 |
| VRS score at rest PoD 1, n (%) | |||
| 0 | 41 (89.1%) | 234 (73.8%) | 0.024 |
| 1 | 4 (8.7%) | 69 (21.8%) | 0.047 |
| 2 | 1 (2.2%) | 13 (4.1%) | 1.000 |
| 3 | 0 | 1 (0.3%) | 1.000 |
| 4 | 0 | 0 | |
| VRS score on movement PoD 1, n (%) | |||
| 0 | 29 (65.9%) | 92 (29.4%) | <0.001 |
| 1 | 11 (19.4%) | 148 (46.8%) | 0.006 |
| 2 | 3 (6.8%) | 52 (16.4%) | 0.118 |
| 3 | 1 (2.3%) | 20 (6.3%) | 0.491 |
| 4 | 0 | 4 (1.3%) | 1.000 |
| VRS score at rest PoD 2, n (%) | |||
| 0 | 42 (93.3%) | 273 (87.5%) | 0.256 |
| 1 | 2 (4.4%) | 32 (10.3%) | 0.284 |
| 2 | 0 | 7 (2.2%) | 0.603 |
| 3 | 1 (2.2%) | 0 | 0.126 |
| 4 | 0 | 0 | |
| VRS score on movement PoD 2, n (%) | |||
| 0 | 26 (59.1%) | 134 (42.8%) | 0.042 |
| 1 | 15 (34.1%) | 118 (37.7%) | 0.632 |
| 2 | 1 (2.3%) | 45 (14.4%) | 0.027 |
| 3 | 1 (2.3%) | 16 (5.1%) | 0.706 |
| 4 | 1 (2.3%) | 0 | 0.124 |
| Pain management failures, PoD 0–3b, n (%) | 22 (31.9%) | 231 (53.8%) | 0.001 |
| Opioid rescue medicationc, n (%) | |||
| PoD 0 | 15 (21.7%) | 228 (53.1%) | <0.001 |
| PoD 1 | 3 (4.3%) | 8 (1.9%) | 0.185 |
| PoD 2 | 5 (7.2%) | 6 (1.4%) | 0.010 |
| PoD 3 | 6 (8.7%) | 5 (1.2%) | 0.002 |
| Switch to different analgesic protocold, n (%) | 14 (20.3%) | 6 (1.4%) | <0.001 |
| Technical failure | 14 (20.3%) | 114 (26.6%) | 0.268 |
| Dislocation | 7 (10.9%) | 4 (0.9%) | |
| Leakage | 4 (6.3%) | 1 (0.2%) | |
| Occlusion | 3 (4.7%%) | 109 (25.8%) | |
CIB + PCA, i.m. continuous infusion of bupivacaine plus i.v. patient-controlled analgesia; PoD, postoperative day; VRS, verbal rating scale (0–4).
A P-value of < 0.05 was considered to indicate statistical significance.
a
Expressed as i.v. morphine equivalent (any route).
b
Pain management failure: need for rescue medication or switch to different opioid.
c
Rescue medication: any additional intravenous, epidural, intramuscular or oral opioid.
d
Switch to different analgesic protocol: change of drug, concentration or infusion rate.