Epidural, intrathecal, and patient-controlled analgesic use in a University Medical Center

Objective: To determine the number and profile of surgical patients receiving epidural, intrathecal, and patient-controlled analgesia. Design: Two-month audit of epidural, intrathecal, and patient-controlled analgesia. Setting: A 300-bed, tertiary care, university medical center. Patients: All patients undergoing surgery and receiving epidural, intrathecal, or patient- controlled analgesia. Results: Of 1123 operations performed during the two- month audit, 185 patients (16 percent) received one of the three forms of analgesia studied. Sixty-three percent of the 185 patients received patient- controlled analgesia and 33 percent received epidural injections for pain control. The most common types of surgery associated with the use of these specialized pain-control techniques were obstetric/gynecologic, orthopedic, general, urologic, and cardiothoracic. Conclusions: Specialized forms of analgesia are becoming increasingly common. Our audit defined the number of patients receiving such therapies according to type of surgery. Collection of such information by other institutions should allow for targeted evaluations of cost-effectiveness (e.g., drug use evaluations).