J Dent Anesth Pain Med.  2016 Dec;16(4):289-294. 10.17245/jdapm.2016.16.4.289.

The evaluation of implementing smart patient controlled analgesic pump with a different infusion rate for different time duration on postoperative pain management

• Kim S
• Jeon Y
• Lee H
• Lim JA
• Park S
• Kim SO

• KMID: 2366157
• DOI: http://doi.org/10.17245/jdapm.2016.16.4.289

Abstract

BACKGROUND
Control of postoperative pain is an important aspect of postoperative patient management. Among the methods of postoperative pain control, patient-controlled analgesia (PCA) has been the most commonly used. This study tested the convenience and safety of a PCA method in which the dose adjusted according to time.
METHODS
This study included 100 patients who had previously undergone orthognathic surgery, discectomy, or total hip arthroplasty, and wished to control their postoperative pain through PCA. In the test group (n = 50), the rate of infusion was changed over time, while in the control group (n = 50), drugs were administered at a fixed rate. Patients' pain scores on the visual analogue scale, number of rescue analgesic infusions, side effects, and patients' satisfaction with analgesia were compared between the two groups.
RESULTS
The patients and controls were matched for age, gender, height, weight, and body mass index. No significant difference in the mount of drug administered was found between the test and control groups at 0-24 h after the operation; however, a significant difference was observed at 24-48 h after the operation between the two groups. No difference was found in the postoperative pain score, number of side effects, and patient satisfaction between the two groups.
CONCLUSIONS
Patient-controlled anesthesia administered at changing rates of infusion has similar numbers of side effects as infusion performed at a fixed rate; however, the former allows for efficient and safe management of postoperative pain even in small doses.

Keyword

Analgesia, Patient-controlled; Infusion pumps; Morphine; Pain; Safety

MeSH Terms

Analgesia
Analgesia, Patient-Controlled
Anesthesia
Arthroplasty, Replacement, Hip
Body Mass Index
Diskectomy
Humans
Infusion Pumps
Methods
Morphine
Orthognathic Surgery
Pain, Postoperative*
Passive Cutaneous Anaphylaxis
Patient Satisfaction
Morphine

Figure

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  Fig. 1 Flow chart

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