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

BBackgrounds: The aim of this study was to compare the effects of different epidural initiation volumes on the 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 old, were included in this randomized, double-blinded study. Combined spinal epidural anesthesia was administered for each cesarean section. The patients were divided into three groups and different volumes (20 ml, 10 ml, and 5 ml) of study drug (0.0625% bupivacaine plus 2 ?g/ml of fentanyl) were administered ninety minutes 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 hours 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.