alexa Epidural versus Intravenous Patient Controlled Analgesia after Laparoscopic Gastric Bypass Surgery | OMICS International | Abstract
ISSN: 2165-7904

Journal of Obesity & Weight Loss Therapy
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Research Article

Epidural versus Intravenous Patient Controlled Analgesia after Laparoscopic Gastric Bypass Surgery

Stefan Neuwersch1, Michael Zink2, Vanessa Stadlbauer-Köllner3 and Karl Mrak4*
1Department of Anaesthesiology and Intensive Care Medicine, General Hospital Klagenfurt, Austria
2Department of Anaesthesiology and Intensive Care Medicine, General public Hospital of the Brothers of St. John of God St.Veit/Glan, Austria
3Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Austria
4Department of Surgery, Division of General surgery, Medical University of Graz, Austria
*Corresponding Author : Karl Mrak
Department of Surgery, Division of General surgery
Medical University of Graz,Auenbruggerplatz 29, 8036-Graz, Austria
Tel: 43-316-385-81548
E-mail: [email protected]
Received: March 25, 2016 Accepted: April 19, 2016 Published: April 22, 2016
Citation: Neuwersch S, Zink M, Stadlbauer-Köllner V, Mrak K (2016) Epidural versus Intravenous Patient Controlled Analgesia after Laparoscopic Gastric Bypass Surgery. J Obes Weight Loss Ther 6:307. doi:10.4172/2165-7904.1000307
Copyright: © 2016 Neuwersch S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction: There is no clear consensus about the optimal postoperative pain management in morbidly obese patients undergoing bariatric surgery. The aim of this study was to evaluate the effects of Patient-Controlled- Epidural-Analgesia (PCEA) compared to Intravenous-Patient-Controlled-Analgesia (IV-PCA) in patients undergoing laparoscopic gastric bypass surgery. Methods: Between January 2013 and December 2014, 154 obese patients underwent laparoscopic gastric bypass surgery. Included in our analyses were all patients receiving either IV-PCA or PCEA in their postoperative course. Group comparison with respect to patient demographics, co-morbidities, details of surgical procedure, details of postoperative course, NRS-scores at rest, and medical follow-ups were performed. Results: Overall 63 (44.4%) patients were treated by PCEA, 79 (55.6%) patients by IV-PCA. We observed no differences across the groups with respect to sex, age, ASA-score, co-morbidities, postoperative BMI, body height, pre- and postoperative weight, ideal weight, weight loss, duration of surgery and postoperative ward. Patient´s BMI (p=0.025) and excess weight before surgery (p=0.029) were significantly higher in the IV-PCA-group. Surgical complications occurred significantly more often in the IV-PCA group (p=0.045). Concerning the postoperative pain management there was no statistically significant difference between different NRS-scores throughout the study period. However, individuals in the IV-PCA-group received significantly more paracetamol (p<0.0001) and diclofenac combined with orphenadrine (p=0.003). Duration of PCA was longer in the PCEA-group compared to patients treated with IV-PCA (p<0.01). Conclusions: Particularly for obese patients, PCEA is more beneficial than IV-PCA, which is borne out by a significantly lower incidence of surgical complications observed in patients receiving PCEA.

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