Patient controlled opioid analgesia versus conventional opioid analgesia for postoperative pain

Hudcova, Jana; McNicol, Ewan D; Quah, Cheng; Lau, Joseph; Carr, Daniel B.

doi:10.1002/14651858.cd003348.pub2

Cited by 254 publications

(195 citation statements)

References 84 publications

Supporting

Mentioning

172

Contrasting

Unclassified

Order By: Relevance

“…2 Patient satisfaction is higher with PCA than with nurse administered intramuscular injections. 3 In addition, caregivers are freed up to attend to other patient needs and patients value not having to request pain medication from caregivers. 4 Although the total dose of drug is greater when patients self administer the agent than when it is nurse administered, 4,5 with the exception of pruritus, PCA is not associated with a greater incidence of adverse effects.…”

Section: Conclusion : L'utilisation Postopératoire Excessive De Morphmentioning

confidence: 99%

“…4 Although the total dose of drug is greater when patients self administer the agent than when it is nurse administered, 4,5 with the exception of pruritus, PCA is not associated with a greater incidence of adverse effects. 3 In spite of these advantages of PCA, we know very little about the factors that govern its effective use. Recent reviews and studies have focused on the role of various PCA parameters; including drugs, [6][7][8] routes, 9,10 doses and lockout intervals, 6,11,12 and background infusion rates, 13 but surprisingly little research has been conducted to understand the psychological and emotional factors that predict effective use of PCA.…”

Section: Conclusion : L'utilisation Postopératoire Excessive De Morphmentioning

confidence: 99%

See 1 more Smart Citation

Locked out and still knocking: predictors of excessive demands for postoperative intravenous patient-controlled analgesia

Katz

Buis

Cohen

2008

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

CAN J ANESTH 55: 2 www.cja-jca.org Februar y, 2008 Background: Psychosocial factors governing the use of postoperative, intravenous patient-controlled analgesia (PCA) have received little attention in spite of the fact that PCA is the most common modality for managing pain after surgery. The motivation behind requests for analgesia during lockout periods is not known. Unrelieved pain and need for pain medication are obvious reasons but other factors may be involved. The aim of the present study was to predict PCA lockout interval demands based on preoperative psychosocial factors.Methods: Approximately one week before major abdominal gynecologic surgery, 117 women completed the impact of events scale (IES) measuring intrusive thoughts and avoidant behaviours. Pain was measured by visual analogue scale at three, six, 12, 24 and 48 hr after surgery. Measures of anxiety and negative affect were obtained 24 and 48 hr after surgery. Cumulative morphine consumption and every PCA demand (drug delivered and not delivered) were downloaded from the PCA pump.Results: Multiple regression analyses revealed that preoperative intrusive thoughts and avoidant behaviours about the upcoming surgery positively predicted PCA lockout interval demands after controlling for postoperative pain, morphine consumption, anxiety, and negative affect (R 2 = 0.45; P < 0.0001). Path analysis showed a direct pathway from preoperative IES scores to lockout interval demands (β = 0.23, P = 0.002) which was not associated with untreated pain, anxiety, or negative affect. Conclusions:Excessive demands for postoperative intravenous-PCA morphine during lockout intervals appear to reflect, in part, poor preoperative adaptation to surgery involving intrusive thoughts and avoidant behaviours about the upcoming surgery.

show abstract

Section: Conclusion : L'utilisation Postopératoire Excessive De Morphmentioning

confidence: 99%

Section: Conclusion : L'utilisation Postopératoire Excessive De Morphmentioning

confidence: 99%

Locked out and still knocking: predictors of excessive demands for postoperative intravenous patient-controlled analgesia

Katz

Buis

Cohen

2008

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…Paracetamol usually provides inadequate analgesia and the side effects of agents like NSAIDs and opioids decrease patient satisfaction [8]. Intravenous PCA provides suitable and safe analgesia in the postoperative period and is superior to conventional analgesia methods [9]. In our clinic, PCA is utilized for effective and continous analgesia and patient comfort in the first 24 h following septoplasty.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Submucosal Tramadol in the Postoperative Treatment of Pain Following Septoplasty Operations

Ekmekçi

Beriat

Bengisun

et al. 2012

Indian J Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

Tramadol is a centrally acting opioid which is effective for moderate-severe pain and is being used for various acute and chronic pain scenarios. The primary endpoint of this controlled, randomized double blind study was to evaluate the effect of submucosal tramadol on VAS scores after septoplasty operations and secondary endpoint was to investigate the effects on total opioid and additional analgesic consumption and patient satisfaction. 60 patients scheduled for septoplasty under general anaesthesia were enrolled. In Group T, at the end of surgery following hemostasis, 2 mg/kg tramadol was applied as submucosal infiltration to both surgical sites, 2 ml (total 4 ml), by the surgeon. In Group P, at the end of surgery following hemostasis, 2 ml isotonic solution (total 4 ml) was applied as submucosal infiltration to both surgical sites by the surgeon. Total opioid consumption, VAS scores, patient satisfaction was evaluated at the end of 24 h VAS values were higher in Group P on the first and second postoperative hours. Patient controlled analgesia demand and delivery values were higher in Group P on the postoperative 1, 2, 4, 6, 12 and 24th hours. Patient satisfaction was higher and opioid consumption was lower in Group T compared to Group P. There was no difference in additional analgesic consumption between two groups. The results show that patients receiving tramadol had lower VAS scores compared with the placebo groups postoperatively.

show abstract

“…Patient satisfaction was assessed at 24 and 48 hr using the VAS. 20 Pain scores at rest and coughing were recorded every six hours during the whole study period. Data recording was done by an independent observer who was unaware of treatment allocation.…”

Section: Methodsmentioning

confidence: 99%

Low-dose sufentanil dœs not potentiate intra-thecal morphine for perioperative analgesia after major colorectal surgery

et al. 2007

View full text Add to dashboard Cite

Purpose: Both intrathecal sufentanil (ITS) and intrathecal morphine (ITM) improve analgesia in obstetrical or cardiac procedures. From a pharmacokinetic standpoint, combining these two opioids may improve perioperative analgesia. We performed a prospective randomized double-blind study to compare the analgesic efficacy of ITM alone vs a mixture of a low dose of ITS plus ITM for perioperative pain relief in colorectal surgery. Methods:Eighty adult patients undergoing colorectal surgery were randomly allocated to receive either 0.4 mg ITM alone or 10 µg ITS plus 0.4 mg ITM before general anesthesia. Intraoperative intravenous sufentanil consumption, postoperative morphine consumption delivered with a patient controlled analgesia device, pain scores, patient satisfaction and adverse effects were recorded for the first 48 hr postoperatively. Results:No differences were observed between groups with respect to intraoperative sufentanil consumption (39 ± 23 µg in group ITM and 40 ± 25 µg in group ITS plus ITM, P = 0.85) and in postoperative morphine consumption in postanesthesia care unit (6 ± 5 mg vs 6 ± 5 mg, P = 0.59), at 24 hr (26 ± 17 vs 24 ± 15 mg, P = 0.59) and at 48 hr (47 ± 31 vs 44 ± 22 mg, P = 0.58). Similarly, no differences were observed in regards to pain relief, patient satisfaction and incidence of adverse effects. Conclusions:These results do not support the addition of 10 µg ITS to 0.4 mg ITM for colorectal surgery, as low dose sufentanil does not improve intraoperative and postoperative analgesia in this setting. post-anesthésiques (6 ± 5 mg vs 6 ± 5 mg, P = 0,59), à 24 h (26 ± 17 vs 24 ± 15 mg, P = 0,59) et à 48 h (47 ± 31 vs 44 ± 22 mg, P = 0,58

show abstract

Patient controlled opioid analgesia versus conventional opioid analgesia for postoperative pain

Cited by 254 publications

References 84 publications

Locked out and still knocking: predictors of excessive demands for postoperative intravenous patient-controlled analgesia

Locked out and still knocking: predictors of excessive demands for postoperative intravenous patient-controlled analgesia

The Efficacy of Submucosal Tramadol in the Postoperative Treatment of Pain Following Septoplasty Operations

Low-dose sufentanil dœs not potentiate intra-thecal morphine for perioperative analgesia after major colorectal surgery

Contact Info

Product

Resources

About