Epidural Analgesia versus Intravenous Patient-Controlled Analgesia: Differences in the Postoperative Course of Cancer Patients

Abstract

Comment: The value of this study is limited only by its design. The 462 consecutive patients undergoing major cancer surgery, enrolled over a 2-yr period, were not randomly assigned to study groups. Furthermore, patients who had apparently successful combined epidural-general anesthesia but failed postoperative epidural analgesia were dropped from the epidural analgesia study group. Interestingly, randomization was not used because of the opinion of the Roswell Park Cancer Institute's Ethics Committee “that it was unethical to randomize patients to a general anesthesia and i.v.-PCA therapy group since in their 6-year experience with routine epidural-general anesthesia, recovery had been longer and complications more prevalent in patients receiving only general anesthesia and i.v.-PCA therapy.”