Patient-Controlled Epidural Analgesia (PCEA) for Patients Who Have Had Major Open Gynecologic Surgery
Postoperative Pain
About this trial
This is an interventional treatment trial for Postoperative Pain focused on measuring Major abdominal or pelvic surgery, Patient-Controlled Epidural Analgesia (PCEA), Length of hospital stay after surgery
Eligibility Criteria
Inclusion Criteria: Women undergoing a laparotomy for major abdominal or pelvic surgery by the gynecology service Patients 18 years or older Patients who have signed an approved informed consent form Exclusion Criteria: Patients undergoing total pelvic exenteration Patients undergoing laparoscopy only Patients undergoing palliative surgery for bowel obstruction Patients undergoing emergent operations Inability to take oral intake Current history of chronic (three months) opioid use or known active alcohol abuse Patients with significant cognitive impairment or documented psychologic impairment Patients with a history of documented anaphylaxis or contraindication to any of the study medications or standardized intraoperative medications will be excluded from study. These include: Morphine Bupivicaine Contraindication to epidural catheter placement. This includes: Documented preoperative coagulopathy: international normalized ratio (INR) < 1.3 and partial thromboplastin time (PTT) < 42 Evidence of infection at potential epidural site Prior extensive spinal surgery or major spinal deformity Platelets > 100K (bleeding diatheses, preoperative use of anti-coagulant with planned use of therapeutic dose of anti-coagulant post-operatively)
Sites / Locations
- Memorial Sloan-Kettering Cancer Center
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
(PCEA)
PCA
patient-controlled epidural analgesia PCEA involves having an epidural catheter placed before surgery.The epidural catheter will be used during surgery to give drugs, such as morphine and a local anesthetic bupivacaine, which will help control pain. After surgery, a constant flow of pain-reducing medicine, such as morphine, will be given through the catheter. This is controlled by the patient.
patient-controlled intravenous analgesia (PCA) PCA involves placing a tube into the patient's vein after surgery. The tube is connected to a pump that is controlled by the patient. The pump holds a medicine, such as morphine, that eases pain.