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Continuous intraoperative epidural infusions affect recovery room length of stay and analgesic requirements: a single-center observational study

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Abstract

Purpose

Continuous intraoperative epidural analgesia may improve post-operative pain control and decrease opioid requirements. We investigate the effect of epidural infusion initiation before or after arrival in the post-anesthesia care unit on recovery room duration and post-operative opioid use.

Methods

We performed a retrospective chart review of abdominal, thoracic and orthopedic surgeries where an epidural catheter was placed prior to surgery at the University of Washington Medical Center during a 24 month period.

Results

Patients whose epidural infusions were started prior to PACU arrival (Group 2: n = 540) exhibited a shorter PACU length of stay (p = .004) and were less likely to receive intravenous opioids in the recovery room (34 vs. 48%; p < .001) compared to patients whose infusions were started after surgery (Group 1: n = 374). Although the highest patient-reported pain scores were lower in Group 2 (5.3 vs. 6.0; p = .030), no differences in the pain scores prior to PACU discharge were observed.

Conclusion

Intraoperative continuous epidural infusions decrease PACU LOS as discharge criteria for patient-reported NRS pain scores are met earlier.

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Acknowledgements

We thank Shu-Fang Newman, MS, Research Software Engineer, for her assistance in constructing the original search query of the institution database associated with our electronic health record system. Funding was provided by National Center for Advancing Translational Sciences (Grant No. UL1TR000423).

Author information

Author notes

  1. Aalap C. Shah

    Present address: Department of Anesthesiology, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA, 90048, USA

Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USA

    Aalap C. Shah, Bala G. Nair & Laurent A. Bollag

  2. Institute for Translational Health Sciences (ITHS), University of Washington, Seattle, WA, USA

    Charles F. Spiekerman

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  1. Aalap C. Shah
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  2. Bala G. Nair
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  3. Charles F. Spiekerman
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  4. Laurent A. Bollag
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Correspondence to Aalap C. Shah.

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The authors have no conflicts of interest.

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Shah, A.C., Nair, B.G., Spiekerman, C.F. et al. Continuous intraoperative epidural infusions affect recovery room length of stay and analgesic requirements: a single-center observational study. J Anesth 31, 494–501 (2017). https://doi.org/10.1007/s00540-017-2316-4

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  • DOI: https://doi.org/10.1007/s00540-017-2316-4

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