Background: Ward-based patient-controlled epidural analgesia (PCEA) for postoperative pain control was introduced at a hospital in Dublin in 2006.  We audited the efficacy and safety of ward-based PCEA from Jan 2006 to Dec 2008.

Method: Data were collected from 928 patients who received PCEA in general surgical wards for postoperative analgesia using bupivacaine 0.125% with fentanyl 2 microg/mL.

Results: On the first postoperative day, the median visual analogue pain score was 2 at rest and 4 on activity.  Hypotension occurred in 21 (2.2%) patients, excessive motor blockade in 16 (1.7%), high block in 5 (0.5%), nausea in 5 (0.5%) and pruritus in only 1 patient.  Excessive sedation occurred in 2 (0.2%) patients but no intervention was required.  There were no serious complications such as epidural abscess, infection or haematoma.

Conclusions: Effective and safe postoperative analgesia can be provided with PCEA in a general surgical ward without recourse to high-dependency supervision.