Comparison of patient-controlled epidural analgesia and intravenous patient-controlled analgesia for postoperative pain in pediatric patients undergoing nuss procedure

Background: Nuss procedure is a severely painful procedure for correcting pectus excavatum, and we conducted a retrospective comparison of patient-controlled epidural anesthesia (PCEA) and intravenous patient-controlled analgesia (IVPCA). Methods: The subjects were 26 pediatric patients aged between 5 to 15 years undergoing the Nuss procedure for pectus excavatum. Pain management was compared in patients with two groups: PCEA and IVPCA. Data collection included patient age and sex, body length, body weight, pain score, surgery/anesthesia times, the length of hospital stays after surgery, the use time of PCA, the rescue dose of analgesic drug, and complications. Results: Age, body length, body weight duration of anesthesia, length of hospital stays after surgery and time of PCA were significantly lower in IVPCA groups than in PCEA. There was no significant difference regarding the rescue dose of analgesic drug. Conclusions: The analgesic effect was not different between PCEA and IVPCA, and IVPCA may be better choice for anesthesiologist who do not have much experience of thoracic epidural anesthesia in children. The management of PONV and multimodal analgesia are needed.