Differences in Postoperative Opioid Consumption in Patients Prescribed Patient-Controlled Analgesia Versus Intramuscular Injection

Context:Experimental assessments can determine pain threshold and tolerance, which mirror sensitivity to pain. This, in turn, influences the post-operative experience.Aims:The study intended to evaluate whether the pre-operative pressure and electrical pain tests can predict pain and opioid requirement following cesarean delivery.Settings and Design:Research was conducted on females scheduled for cesarean section at a tertiary care hospital of the state. Twenty women were enrolled, after obtaining written informed consent.Materials and Methods:Pain assessment was performed on the eve of cesarean sections using three devices: PainMatcher; determined electrical pain threshold while the algometers PainTest™ FPN100 (manual) and PainTest™ FPX 25 (digital) evaluated pressure pain threshold and tolerance. Post-operative pain relief included intravenous morphine administered by patient-controlled analgesia, diclofenac (100 mg, every 12 h, rectally, enforced) and paracetamol (1000 mg, every 4-6 h, orally, on patient request). Pain scores were reported on numerical rating scales at specified time intervals.Statistical Analysis Used:Correlational and regression statistics were computed using IBM SPSS Statistics 21 software (IBM Corporation, USA).Results:A significant correlation was observed between morphine requirement and: (1) electrical pain threshold (r = -0.45, P = 0.025), (2) pressure pain threshold (r = -0.41 P = 0.036) and (3) pressure pain tolerance (r = -0.44, P = 0.026) measured by the digital algometer. The parsimonious regression model for morphine requirement consisted of electrical pain threshold (r2= 0.20, P = 0.049). The dose of morphine consumed within 48 h of surgery decreases by 0.9 mg for every unit increment in electrical pain threshold.Conclusions:The predictive power of pain sensitivity assessments, particularly electrical pain threshold, may portend post-cesarean outcomes, including opioid requirements.

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“…Whether PCA reduces the opioid consumption and side-effects remains questionable and different studies provide conflicting evidence. [252627]…”

Section: Discussionmentioning

confidence: 99%

Pre-operative pain sensitivity: A prediction of post-operative outcome in the obstetric population

Buhagiar

Cassar

Brincat

et al. 2013

J Anaesthesiol Clin Pharmacol

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“…Everett et al studied the rate of analgesic drugs dosage in the PCA and intramuscular injection groups in Australia. The results showed that the mean amount of medication within three days after operation in the PCA was higher than that of the intramuscular group (17).…”

Section: Discussionmentioning

confidence: 81%

The Effect of Patient-controlled Analgesia on Intensity of Postoperative Pain in Abdominal Surgeries

Shariati

Aghamollaee

Fayazi

et al. 2014

Jentashapir J Health Res

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Background: Unrelieved pain after surgery can lead to increased postoperative complications, prolonged hospital stay and delayed recovery. Patient-controlled analgesia (PCA) has emerged as a standard technique to manage acute postoperative pains. Objectives: The current study aimed to compare the effect of PCA and routine method on Intensity of post-operation pain in abdominal surgeries. Patients and Methods: It was an interventional study conducted on thirty patients admitted to Amir-al-momenin Hospitalin Ahvaz , Iran, in 2009. About 60 patients participated in the current study. The patients were randomly divided into two groups. The intervention group used PCA devices and the control group received the routine pain relief protocol. Measurement tools were demographic characteristic questionnaire, check list of vital signs and adverse effects and visual analog scale (VAS). Vital signs, pain severity, drug consumption and adverse effects were assessed every six hours during 24 hours after surgery. Then data were analyzed by SPSS version 16,χ2, and t-test Results: There was a significant difference between the mean of pain severity and the amount of medications used by patients after surgery (P≤0.001). But there was no significant difference between vital signs and side effects between the two groups. Conclusions: These findings indicate the usefulness of PCA compared to the routine methods on pain relief after operation.Therefore this method can be recommended to alleviate postoperative pain.

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“…Also the study found that there are no significant differences with regards to demographic characteristic of patients that adds to the inconsistent reports related to the role of demographics on the effective use of PCA. While Everett and Salamonson (2005) found that demographic characteristics have no significant role in the difference between PCA and other methods, Grass (2005) reported that personal characteristics of patients do influence the effective use of PCA.…”

Section: Discussionmentioning

confidence: 98%

“…A question remained about the differences between PCA and other methods of pain management. Although Everett and Salamonson (2005) found that demographic characteristics have no significant role in the difference between PCA and other methods, Grass (2005) maintained that personal characteristics of patients do influence the effective use of PCA.…”

Section: Introductionmentioning

confidence: 97%

Patient Satisfaction About Using Patient Controlled Analgesia in Managing Pain Post Surgical Intervention

et al. 2013

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Management of postoperative pain using patient controlled analgesia (PCA) has increased for its proven advantages over conventional methods of pain control. The purpose of this study was to investigate patients' satisfaction about using PCA post surgical intervention among patients at Saudi health care settings. A cross-sectional, descriptive correlational design was used to collect data from patients using PCA post surgical interventions. The analysis showed that patients had a moderate to high level of perception about efficacy of PCA, and had a moderate level of knowledge about PCA use and its function. The duration of using a PCA pump, patients' age, gender, marital status, educational level, type of surgery, and their work status were significant predictors (F 7, 76 = 5.13, p < .001; R(2) = 0.59). PCA offers patients with an individualized analgesic therapy that meets the patients' demand of pain control. The implications for nurses and medical staff are discussed.

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Differences in Postoperative Opioid Consumption in Patients Prescribed Patient-Controlled Analgesia Versus Intramuscular Injection

Cited by 67 publications

References 51 publications

Pre-operative pain sensitivity: A prediction of post-operative outcome in the obstetric population

Pre-operative pain sensitivity: A prediction of post-operative outcome in the obstetric population

The Effect of Patient-controlled Analgesia on Intensity of Postoperative Pain in Abdominal Surgeries

Patient Satisfaction About Using Patient Controlled Analgesia in Managing Pain Post Surgical Intervention

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