INTRAVENOUS VERSUS EPIDURAL ROUTES OF PATIENT-CONTROLLED ANALGESIA IN ABDOMINAL SURGERY: SYSTEMATIC REVIEW WITH META-ANALYSIS

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dc.contributor.authorViderman, Dmitriy
dc.contributor.authorTapinova, Karina
dc.contributor.authorNabidollayeva, Fatima
dc.contributor.authorTankacheev, Ramil
dc.contributor.authorAbdildin, Yerkin G.
dc.date.accessioned2022-07-20T09:11:19Z
dc.date.available2022-07-20T09:11:19Z
dc.date.issued2022
dc.description.abstractObjective: 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 cautionen_US
dc.identifier.citationViderman, D., Tapinova, K., Nabidollayeva, F., Tankacheev, R., & Abdildin, Y. G. (2022). Intravenous versus Epidural Routes of Patient-Controlled Analgesia in Abdominal Surgery: Systematic Review with Meta-Analysis. Journal of Clinical Medicine, 11(9), 2579. https://doi.org/10.3390/jcm11092579en_US
dc.identifier.urihttp://nur.nu.edu.kz/handle/123456789/6483
dc.language.isoenen_US
dc.publisherJournal of Clinical Medicineen_US
dc.rightsAttribution-NonCommercial-ShareAlike 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/us/*
dc.subjectType of access: Open Accessen_US
dc.subjectpatient-controlled analgesiaen_US
dc.subjectepidural analgesiaen_US
dc.subjectintravenous analgesiaen_US
dc.subjectpain controlen_US
dc.subjectabdominal surgeryen_US
dc.subjectpostoperative painen_US
dc.titleINTRAVENOUS VERSUS EPIDURAL ROUTES OF PATIENT-CONTROLLED ANALGESIA IN ABDOMINAL SURGERY: SYSTEMATIC REVIEW WITH META-ANALYSISen_US
dc.typeArticleen_US
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