Clin Should Elbow.  2015 Dec;18(4):237-241. 10.5397/cise.2015.18.4.237.

An Analysis on the Effect of Patient-controlled Analgesia Performed by Orthopaedic Department or Postoperative Pain Control after Shoulder and Elbow Surgery

• Yum JK
• Kim JH
• Boo KH
• Ahn SH

• KMID: 2171440
• DOI: http://doi.org/10.5397/cise.2015.18.4.237

Abstract

BACKGROUND
We investigated the effectiveness of pain management and the adverse events of intravenous (IV) patient-controlled analgesia (PCA) after orthopedic surgery.
METHODS
From September 2014 and August 2015, we performed a retrospective analysis of 77 patients who underwent orthopedic surgery of the shoulder or the elbow in our hospital. The composition of the intravenous PCA administered to the patients was as follows: 250 mg of dexketoprofen trametamol, 70 mg of oxycodone, and 0.6 mg of ramosetron, which were made up to 79 ml of normal saline. We evaluated and statistically analyzed the difference in the visual analogue scale (VAS) scores for pain at immediate postoperation, at 24 hours of PCA, at 72 hours of PCA, and after discontinuation of PCA and in the incidence of adverse events.
RESULTS
We found that VAS score decreased for 3 postoperative days and that with discontinuation of IV PCA a meaningful change in VAS score was no longer seen. Of the 77 patients, 22 presented with adverse events (28.6%). We terminated IV PCA temporarily in the 21 patients who presented with adverse events; we terminated analgesia permanently in one patient (1.2%). Consequently, 76 of 77 patients carried out IV PCA till the designated period.
CONCLUSIONS
Intravenous PCA after orthopedic surgery of the shoulder or the elbow may be accompanied with adverse events. Careful assessment of the patient and treatment of the adverse outcomes are key to a successful maintenance of PCA and to a successful management of postoperative pain.

Keyword

Patient-controlled analgesia; Non-steroidal anti-inflammatory agents; Oxycodone; Ramosetron; Pain measurement

MeSH Terms

Analgesia
Analgesia, Patient-Controlled*
Anti-Inflammatory Agents, Non-Steroidal
Elbow*
Humans
Incidence
Orthopedics
Oxycodone
Pain Management
Pain Measurement
Pain, Postoperative*
Passive Cutaneous Anaphylaxis
Retrospective Studies
Shoulder*
Anti-Inflammatory Agents, Non-Steroidal
Oxycodone