Epidural Analgesia Versus Patient-Controlled Analgesia for Pain Relief in Uterine Artery Embolization for Uterine Fibroids: A Decision Analysis
| Autor: | Willem M. Ankum, Lobke M. Moolenaar, Sanne M. van der Kooij, Wouter J. K. Hehenkamp, Ben W.J. Mol, Jim A. Reekers |
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| Přispěvatelé: | Obstetrics and gynaecology, ICaR - Ischemia and repair, Amsterdam Cardiovascular Sciences, Obstetrics and Gynaecology, Other departments, Other Research, Radiology and Nuclear Medicine, Amsterdam Public Health |
| Rok vydání: | 2013 |
| Předmět: |
Adult
medicine.medical_specialty Uterine fibroids Cost-Benefit Analysis medicine.medical_treatment Pain relief Decision Support Techniques Uterine artery embolization medicine Humans Pain Management Radiology Nuclear Medicine and imaging Embolization health care economics and organizations Pain Measurement Leiomyoma business.industry Patient-controlled analgesia Analgesia Patient-Controlled Uterine Artery Embolization medicine.disease Surgery Analgesia Epidural Treatment Outcome Anesthesia Uterine Neoplasms Female Cardiology and Cardiovascular Medicine Complication business Decision analysis Abdominal surgery |
| Zdroj: | CardioVascular and Interventional Radiology, 36(6), 1514-1520. Springer Verlag Cardiovascular and interventional radiology, 36(6), 1514-1520. Springer Verlag van der Kooij, S M, Moolenaar, L M, Ankum, W M, Reekers, J A, Mol, B J & Hehenkamp, W J K 2013, ' Epidural Analgesia Versus Patient-Controlled Analgesia for Pain Relief in Uterine Artery Embolization for Uterine Fibroids: A Decision Analysis ', CardioVascular and Interventional Radiology, vol. 36, no. 6, pp. 1514-1520 . https://doi.org/10.1007/s00270-013-0607-1 |
| ISSN: | 1432-086X 0174-1551 |
| DOI: | 10.1007/s00270-013-0607-1 |
| Popis: | This study was designed to compare the costs and effects of epidural analgesia (EDA) to those of patient-controlled intravenous analgesia (PCA) for postintervention pain relief in women having uterine artery embolization (UAE) for systematic uterine fibroids. Cost-effectiveness analysis (CEA) based on data from the literature by constructing a decision tree to model the clinical pathways for estimating the effects and costs of treatment with EDA and PCA. Literature on EDA for pain-relief after UAE was missing, and therefore, data on EDA for abdominal surgery were used. Outcome measures were compared costs to reduce one point in visual analogue score (VAS) or numeric rating scale (NRS) for pain 6 and 24 h after UAE and risk for complications. Six hours after the intervention, the VAS was 3.56 when using PCA and 2.0 when using EDA. The costs for pain relief in women undergoing UAE with PCA and EDA were 191 and 355, respectively. The costs for EDA to reduce the VAS score 6 h after the intervention with one point compared with PCA were 105 and 179 after 24 h. The risk of having a complication was 2.45 times higher when using EDA. The results of this indirect comparison of EDA for abdominal surgery with PCA for UAE show that EDA would provide superior analgesia for post UAE pain at 6 and 24 h but with higher costs and an increased risk of complications |
| Databáze: | OpenAIRE |
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