Comparison of the antalgic effects of epidural and intravenous patient-controlled analgesia with fentanyl after cesarean section

Objective To compare the effects of patient-controlled intravenous analgesia(PCIA) with patient-controlled epidural analgesia(PCEA) with fentanyl after cesarean section.Methods 60 patients undergoing cesarean section were randomly assigned into two groups: group PCIA and group PCEA,30 cases for each group.The analgesic solution for PCIA was fentanyl(20ug/kg) plus tropisetron(5mg),and that for PCEA was fentanyl(5ug/kg) plus 1.192% ropivacaine.The analgesia and sedation efficacy was assessed by visual analogue scale(VAS) and Ramsay sedation score(RSS).The plasma prolaction concentrations,the recovery of bowel movement,the adverse effects during analgesia period were observed.Results The efficacy of analgesia in group PCEA was better than that in group PCIA.The RSS score was significantly higher in group PCIA than that in group PCEA.No significant difference was found in the overall satisfaction on analgesia therapy.The incidence of dizziness in group PCIA was higher than that in group PCEA.There was no significant difference between two groups in the recovery of bowel movement,the plasma level of prolactin,nausea,vomiting,pruritus and respiration frequency.Conclusions PCIA with PCEA could provide similar analgesia efficacy using fentanyl in patients undergoing cesarean section.Both PCIA and PCEA have less adverse effects.