Patient‐controlled analgesia: a controlled trial

Abstract

Thirty-six patients undergoing lower abdominal surgery were included in a prospective randomized controlled study to compare the effects of patient-controlled analgesia (PCA) and a standard intramuscular/intravenous treatment (conventional analgesia, CA) of postoperative pain. Morphine was used in both groups. There were no significant differences between the two analgesic regimens in respect of linear analogue pain scores, verbal pain-relief scores, amount of morphine used or side-effects. No treatment-induced alterations in vital values were experienced.

Patient‐controlled analgesia: a double‐blind study in burn patients

“…In the present study, the intravenous route was employed in both analgesic regimens to ensure that methods were compared rather than routes of administration. The results showed comparable levels of drug intake in the two treatment groups, a finding consistent with more recent studies [8,24,25].…”

“…Several authors [9,16] argue that PCA pumps provide a substantial placebo effect. Others [2,8] maintain that a key factor in PCA success is the patients' satisfaction resulting from the feeling of being in control. In other words, success of PCA therapy may not only lie in the actual superiority of the technique but may involve other factors.…”

“…However, many of these studies were poorly controlled and showed methodological shortcomings [3]. Recent studies [8,9] have used more carefully controlled design to compare PCA with traditional pain therapy, but two methodological problems still persist. Firstly, in all trials where PCA is compared with intermittent intramuscular injections of analgesics, the drug is administered by two different routes (i.e.…”

Is outpatient laparoscopic cholecystectomy wise?

“…The PCA machines were set with no basal rate of morphine, so morphine usage would accurately reflect patients' needs. The literature consistently reports, however, that PCA machines lead to a wide range of narcotic use postoperatively typical for selfadministered or "on-demand" systems of analgesia [3,9,30] Our results show that a wide range of morphine use from 0 mg to greater than 30 mg is seen on the day of surgery following laparoscopic cholecystectomy. The goal of postoperative analgesics is to provide maximal analgesia and satisfaction with minimal side effects and sedation.…”

Comparison between patient-controlled analgesia and intramuscular meperidine after thoracotomy

“…Comparable levels of meperidine intake were found in the two treatment groups, a finding consistent with more recent studies. 21,26,27 Considerable variability was observed in the amount of medication that patients required after thoracotomy. Interpatient variation was especially striking in the PCA group where meperidine consumption varied ten-fold.…”