Abstract
We present the indications of patient-controlled epidural analgesia (PCEA) for postoperative analgesia. In postoperative epidural analgesia, it is known that the addition of patient-controlled analgesia (PCA) provided similar analgesia with less drug consumption compared to continuous epidural infusion alone. Therefore, PCEA should be applied in postoperative epidural analgesia whenever the PCA system is not contraindicated. The major advantages of epidural analgesia over IV-PCA, such as providing superior analgesia upon movement, reducing postoperative pulmonary complications, and hastening the return of gastrointestinal function, are attractive after major thoracic, abdominal, hip or knee surgeries. On the other hand, postoperative epidural analgesia could potentially cause extremely rare but catastrophic central nervous system complications, and a recent increase in patients requiring perioperative anticoagulation therapy restricts the indication of postoperative epidural analgesia. Accordingly, coagulation status in surgical patients and pharmacological prophylaxis of venous thromboembolism should always be taken into consideration for PCEA.
