Epidural analgesia is generally regarded as superior to
intravenous opioids (Macintyre and Schug, 2007) so it is
not unreasonable to assume that epidural respondents would
score more positively overall. However, this study found no
difference between epidural analgesia or patient-controlled
analgesia. Similarly, the weaning from sophisticated analgesia
to oral medications has been recognised as a potential time
when pain management can falter (Brown et al, 2007; Philips
et al, 2010). ‘Transitional analgesia’ involves the use of longacting
opioids following epidural analgesia to prevent any
sudden decreases in pain relief (Brown et al, 2007). A similar
strategy is used for PCA patients, using previous opioid
requirements to calculate an equivalent oral dose.