Soonchunhyang Med Sci.  2022 Jun;28(1):7-14. 10.15746/sms.22.002.

Comparative Efficacy of Mechanical Patient-Controlled Analgesia Pump Operated in Patient Optimizing Background Infusion Mode and Conventional Nonmechanical Pump after Laparoscopic Surgery

• Kim NS
• Park SK

• KMID: 2531501
• DOI: http://doi.org/10.15746/sms.22.002

Abstract

Objective
The aim of this study was to evaluate the efficacy and side effects of the mechanical patient-controlled analgesia (PCA), pumps operated in patient optimizing background infusion (POBI) mode, compared with the conventional nonmechanical PCA after laparoscopic gynecologic surgery.
Methods
In total, 211 patients were randomized to nonmechanical pump (n=106, group A) or mechanical pump (n=105, group P) postoperative pain treatment groups. A single blinded observer evaluated and recorded postoperative nausea and vomiting (PONV) score as well as the background infusion rate, Numeric Rating Scale (NRS), use of an additional antiemetic or analgesic, degree of sedation, and other side effects at 30 minutes, 2 hours, 8 hours, and 24 hours postoperatively. The degree of patient satisfaction was evaluated at 2 and 24 hours postoperatively.
Results
There was no significant difference in the overall NRS score between the two groups. However, the use of rescue analgesics was significantly higher in group A (P=0.007). The incidence of PONV did not significantly differ between the two groups at 0.5 hours postoperatively; however, at 2 hours, it was significantly higher in group P than in group A (P=0.003). In contrast, the incidence of PONV was significantly lower in group P than in group A at 24 hours postoperatively (P=0.033). No significant group difference was observed in patient satisfaction.
Conclusion
With an appropriate waiting time, a mechanical pump operating in POBI mode could be an effective PCA pump to reduce postoperative pain and side effects.

Keyword

Patient-controlled analgesia; Fentanyl; Gynecologic surgical procedures; Infusion pumps; Pain management; Postoperative pain; Postoperative nausea and vomiting