Intravenous versus Epidural Routes of Patient-Controlled Analgesia in Abdominal Surgery: Systematic Review with Meta-Analysis
Viderman D. Tapinova K. Nabidollayeva F. Tankacheev R. Abdildin Y.G.
May-1 2022MDPI
Journal of Clinical Medicine
2022#11Issue 9
Objective: To compare the intravenous and epidural routes of patient-controlled anesthesia in abdominal surgery. Methods: We searched for randomized clinical trials that compared the intravenous and epidural modes of patient-controlled anesthesia in intra-abdominal surgery in adults. Data analysis was performed in RevMan 5.4. Heterogeneity was measured using I2 statistic. Risk of bias was assessed using the Jadad/Oxford quality scoring system. Results: Seven studies reporting 529 patients were included into the meta-analysis. For pain at rest, the mean difference with 95% confidence interval (CI) was −0.00 [−0.79, 0.78], p-value 0.99, while for pain on coughing, it was 0.43 [−0.02, 0.88], p-value 0.06, indicating that patient-controlled epidural analgesia (PCEA) was superior. For the sedation score, the mean difference with 95% CI was 0.26 [−0.37, 0.89], p-value 0.42, slightly favoring PCEA. For the length of hospital stay, the mean difference with 95% CI was 1.13 [0.29, 1.98], p-value 0.009, favoring PCEA. For postoperative complications, the risk ratio with 95% CI was 0.8 [0.62, 1.03], p-value 0.08, slightly favoring patient-controlled intravenous analgesia (PCIVA). A significant effect was observed for hypotension, favoring PCIVA. Conclusions: Patient-controlled intravenous analgesia compared with patient-controlled epidural analgesia was associated with fewer episodes of hypotension. PCEA, on other hand, was associated with a shorter length of hospital stay. Pain control and other side effects did not differ significantly. Only three studies out of seven had an acceptable methodological quality. Thus, these conclusions should be taken with caution.
abdominal surgery , epidural analgesia , intravenous analgesia , pain control , patient-controlled analgesia , postoperative pain
Text of the article Перейти на текст статьи
Department of Biomedical Sciences, Nazarbayev University School of Medicine (NUSOM), Kerei, Zhanibek khandar Str. 5/1, Nur-Sultan, 020000, Kazakhstan
Department of Anesthesiology and Intensive Care, National Research Oncology Center, Kerei, Zhanibek khandar Str. 3, Nur-Sultan, 020000, Kazakhstan
Department of Mechanical and Aerospace Engineering, School of Engineering and Digital Sciences, Nazarbayev University, 53 Kabanbay Batyr Ave., Nur-Sultan, 010000, Kazakhstan
Pain Management Department, National Neurosurgery Center, 34/1 Turan Ave., Nur-Sultan, 010000, Kazakhstan
Department of Biomedical Sciences
Department of Anesthesiology and Intensive Care
Department of Mechanical and Aerospace Engineering
Pain Management Department
10 лет помогаем публиковать статьи Международный издатель
Книга Публикация научной статьи Волощук 2026 Book Publication of a scientific article 2026