[A comparison of patient-controlled epidural analgesia and intravenous fentanyl analgesia for laparoscopic ovarian cystectomy].

BACKGROUND: Laparoscopic ovarian cystectomy (LOC) can be performed in conjunction with patient-controlled epidural analgesia (PCEA) or intravenous fentanyl analgesia (IFA). Therefore, we evaluated the postoperative pain associated with both analgesia methods. METHODS: We retrospectively evaluated the postoperative pain associated with PCEA and IEA. We calculated the combined remifentanil and fentanyl effect-site concentrations (ESC) in 43 patients at 1-2 hours after operations involving PCEA (n = 24, group E) or IFA (n = 19, group F). We also evaluated the supplementary analgesics required and the incidences of decreased respiratory rate and desaturation. RESULTS: The patients' backgrounds were similar in both groups. The ESC was below 1.0 ng x ml(-1) in group E and 1.0-2.0 ng x ml(-1) in group F. In group E, five patients received supplementary local bolus injections, one received an NSAID, and one received a morphine injection, while four received NSAIDs and one received a morphine injection in group F. Thus, supplementary analgesics used for 7/24 patients in group E and 5/19 patients in group F (P = 1.000). No complications were noted in either group. CONCLUSIONS: Both PCEA and IFA regimens can effectively manage postoperative pain with relatively low amounts of supplementary analgesics.