TITLE:
Comparing Epidural Analgesia and ON-Q Infiltrating Catheters for Pain Management after Hepatic Resection
AUTHORS:
Jose M. Soliz, Rodolfo Gebhardt, Lei Feng, Wenli Dong, Margaret Reich, Steven Curley
KEYWORDS:
Hepatic Resection; Epidural; On-Q Catheter; Postoperative Pain Control
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.3 No.1,
January
31,
2013
ABSTRACT: Background and Objectives: Pain
control after hepatic resection presents unique challenges as subcostal
incisions, rib retraction, and diaphragmatic irritation can lead to significant
pain. Both epidural analgesia and ON-Q catheters have been used for postoperative
pain management after hepatic surgery, but to our knowledge have not been
directly compared. Methods: The records of 143 patient between the ages 18 and
70 were reviewed who underwent hepatic resection by a single surgeon. Patients
were categorized according to method of postoperative pain control. Average
pain scores for both study groups were collected until POD#3. Results:
Demographic data and the length of surgery were similar between the groups (all P > 0.05). On the day of surgery and
POD#1, average pain scores for the epidural group were lower than the ON-Q
group (P 0.0001 and P = 0.0008 respectively). There was no
difference in pain scores on POD #2 (P = 0.2369) or POD #3
(P = 0.2289). Conclusions: Epidural
analgesia provides superior pain control on the day of surgery and POD#1 when
compared to On-Q catheter with IV PCA. There was no difference in pain scores
on POD#2 or POD#3. Future prospective randomized trials comparing these
analgesic methods will be required to further evaluate enhanced recovery after
hepatic surgery.