Correlations between patient-controlled epidural analgesia requirements and individual characteristics among gynecologic patients.

BACKGROUND Patient-controlled epidural analgesia (PCEA) has been used widely to relieve postoperative pain. Although many studies have demonstrated the safety and effectiveness of PCEA, the relationship between patients' characteristics and requirements of PCEA has not been investigated yet. We conducted this retrospective study to explore the correlations between total PCEA demand and patients' characteristics. METHODS We collected data from patients aged from 20 to 65, receiving gynecologic operations and consenting to epidural analgesia. All patients used postoperative PCEA for at least 3 days. An analgesic solution of bupivacaine (0.0625%) and morphine (0.02 mg/mL) was prepared for PCEA in all patients. The total PCEA consumption was recorded at the end of the 3-day course. Stepwise regression analysis was conducted to sort out influential factors which could determine the total PCEA demand. RESULTS There were 170 patients (81 benign and 89 malignant cases) included in the analysis. Significant differences existed in age and total PCEA requirement between different disease patterns. The stepwise regression model selection showed that disease patterns, body mass index (BMI) and age were most significant determinants of total PCEA demand. The R and adjusted R square values of the final selected model are 0.339 and 0.099, respectively. The comparison between the standardized regression coefficient of BMI and age suggested that the influence of BMI is greater than that of age. CONCLUSIONS Disease patterns, BMI and age are associated with total PCEA requirements. Gynecologic patients receiving procedures for malignant diseases consumed more PCEA solution than benign cases. Height is not associated with total PCEA demand. There is a close correlation between BMI and PCEA consumption but age is a negative correlate.

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