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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Musculoskeletal Disorders 1/2015

Comparison of patient-controlled epidural analgesia and patient-controlled intravenous analgesia after spinal fusion surgery: a meta-analysis of randomized controlled trials

BMC Musculoskeletal Disorders > Ausgabe 1/2015
Peng Tian, Xin Fu, Zhi-jun Li, Xin-long Ma
Wichtige Hinweise
Peng Tian and Xin Fu contributed equally to this work.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

P.T., X.F. conducted literature search and determined studies for exclusion and inclusion. P.T., X.F. and Z.J.L. extracted data from the included studies, performed the meta-analysis, and drafted the manuscript. P.T., X.F. and X.L.M. conceived the idea of the study, designed the study, and critically revised the manuscript for important intellectual content. All authors reviewed the paper and approved the final manuscript.



The objective of this meta-analysis was to compare the efficacy and safety of patient-controlled epidural analgesia (PCEA) and patient-controlled intravenous analgesia (PCIA) in postoperative analgesia of spinal fusion surgery.


Potential academic articles were identified from the Cochrane Library, Medline (1966–2015.5), PubMed (1966–2015.5), Embase (1980–2015.5) and ScienceDirect (1966–2015.5). Gray studies were identified from the references of the included literature. Randomized controlled trials (RCTs) involving PCEA and PCIA after spinal fusion were included. Two independent reviewers performed independent data abstraction. I2 statistic was used to assess heterogeneity. Fixed or random effects model was used for meta-analysis.


Eight RCTs met the inclusion criteria. There was a better analgesic effect in patients with PCEA for postoperative VAS on the first day (P = 0.0005) and second day (P = 0.006). The patients with PCEA had a higher incidence of pruritus (P = 0.02) and paresthesia (P = 0.03) after surgery than those with PCIA. There was no statistically significant difference in postoperative VAS on the third day (P = 0.15), nausea (P = 0.74) or emesis (P = 0.37) between the two groups.


After spinal fusion, the patients with PCEA have similar analgesic efficacy during the three postoperative days and a higher incidence of pruritus and paresthesia than those with PCIA. Due to the limited quality and data of the evidence currently available, more high-quality randomized controlled trials are required.
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