Effects of different epidural initiation volumes on postoperative analgesia in cesarean section

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Kaçmaz O., Gülhaş N., Erdoğan Kayhan G., Durmuş M.

Turkish journal of medical sciences, vol.50, pp.1955-1962, 2020 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 50
  • Publication Date: 2020
  • Doi Number: 10.3906/sag-1905-44
  • Journal Name: Turkish journal of medical sciences
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.1955-1962
  • Keywords: Cesarean section, combined spinal epidural anesthesia, patient-controlled epidural analgesia, postoperative pain, RANDOMIZED-TRIAL, PAIN-CONTROL, DOUBLE-BLIND, ANESTHESIA, DELIVERY, LABOR, BUPIVACAINE, DEXMEDETOMIDINE, LEVOBUPIVACAINE, INTERMITTENT
  • Eskisehir Osmangazi University Affiliated: Yes



Background/aim: The aim of this study was to compare the effects of different epidural initiation volumes on postoperative pain scores, analgesic requirements, and side effects in pregnant women administered patient-controlled epidural analgesia (PCEA) for postoperative pain after cesarean sections.

Materials and methods: Eighty-one pregnant women, aged 18–45 years, were included in this randomized, double-blind study. Combined spinal epidural anesthesia was administered for each cesarean section. The patients were divided into 3 groups and different volumes (20 mL, 10 mL, and 5 mL) of the study drug (0.0625% bupivacaine plus 2 μg/mL of fentanyl) were administered 90 min after the spinal block via epidural catheter. The visual analogue scale (VAS) scores at rest and during movement, first PCEA dose time, number of PCEA doses required per hour, total analgesic consumed, and side effects were recorded postoperatively.

Results: There were no statistically significant differences among the groups in terms of the VAS rest and VAS movement scores. The times to the first analgesic dose requirement were longer in Group 10 and Group 20 than in Group 5. The analgesic requirement during the first 2 h was lower in Group 20 than in the other groups.

Conclusions: The PCEA initiations with different volumes provided similar pain scores. However, the 20 mL volume resulted in a lower analgesic dose requirement during the early postoperative period, and it also delayed the requirement for analgesia.

Keywords: Cesarean section; combined spinal epidural anesthesia; patient-controlled epidural analgesia; postoperative pain.