MONDAY, July 24, 2023 (HealthDay News) — Initiating patient-controlled epidural anesthesia (PCEA) infusion in the operating room (OR) may improve pain control, according to a study presented at the annual American Society of Anesthesiologists Anesthesia Quality and Patient Safety Meeting, held virtually from July 14 to 15.

Murphy Owens, M.D., from Weill Cornell Medicine in New York City, and colleagues examined the rate of intraoperative PCEA use and developed an improved workflow to start PCEA use in the OR. Charts were reviewed from December 2022 through February 2023 to examine PCEA connected to epidurals intraoperatively and by postanesthesia care unit (PACU) arrival. Postintervention feedback surveys on the new streamlined workflow were conducted with certified registered nurse anesthetists, residents, and attending anesthesiologists.

The researchers found that at the start of the project, very few epidural infusions were started in the OR, while at two months after the intervention, 90 percent were started in the OR. On survey of 16 anesthesiologists and 13 nurses regarding their experience with the new workflow, 56 and 79 percent, respectively, said patients were more comfortable when they arrived in the PACU; 56 and 79 percent, respectively, said patients required fewer intravenous or oral opioids; and 50 and 79 percent, respectively, said they were more satisfied with the new workflow.

“Effective pain management after surgery is a crucial issue in health care, and this streamlined approach for initiating epidural infusions in the OR reduces delays in the patient getting pain relief,” Owens said in a statement. “Additionally, research shows that using a PCEA can reduce patients’ need for opioids to manage their pain.”

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