Postoperative patient-controlled analgesia: Meta-analyses of initial randomized control trials

Ballantyne, Jane C.; Carr, Daniel B.; Chalmers, Thomas C.; Dear, Keith; Angelillo, Italo Francesco; Mosteller, Frederick

doi:10.1016/0952-8180(93)90013-5

Cited by 377 publications

(205 citation statements)

References 20 publications

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“…This choice of the primary outcome reflects the subjective nature of the pain severity scores and the influence of anxiety, catastrophisation, use of patientcontrolled analgesia, and aggressiveness of postoperative physiotherapy. [29][30][31] For this review, verbal rating scale scores and pain numerical rating scale (NRS) scores were converted 32 to 0-10 visual analogue scale (VAS) scores, where 10 = worst pain imaginable, and 0 = no pain. The amounts of all postoperative opioid analgesics consumed during the first 48 hr were converted to equianalgesic doses of morphine.…”

Section: Definition Of Relevant Outcome Datamentioning

confidence: 99%

Is sciatic nerve block advantageous when combined with femoral nerve block for postoperative analgesia following total knee arthroplasty? a meta-analysis

Abdallah

Madjdpour

Brull

2016

Can J Anesth/J Can Anesth

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Section: Definition Of Relevant Outcome Datamentioning

confidence: 99%

Is sciatic nerve block advantageous when combined with femoral nerve block for postoperative analgesia following total knee arthroplasty? a meta-analysis

Abdallah

Madjdpour

Brull

2016

Can J Anesth/J Can Anesth

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“…2 Initially touted as being able to decrease opioid usage and decrease hospital stay, further studies have shown that PCA leads to increased patient satisfaction and greater analgesic efficacy when compared with im injections. 6 More recently, many treatment modalities are either currently undergoing cost-effectiveness analyses or being suggested to do so. 7 Early studies have suggested that PCA is more cost-effective than either im or epidural analgesia, s-l~ Patients, however, are not involved with this process.…”

mentioning

confidence: 99%

Patient attitudes regarding pca and associated costs

1997

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Patient attitudes regarding pca and associated costsPurpose: To determine patients' knowledge and attitudes towards patient-controlled analgesia (PCA) costs through the use of our acute pain service quality assurance (QA) programme. Methods: Quality Assurance questionnaires were distributed to all patients receiving PCA opio~ds for > 12 hr. Patients were asked to note the presence of side effects (nausea/vomiting, pruritus, urinary retention), to indicate their satisfaction with regard to their pain relief, follow-up assessments, treatment of side effects, and to recall the previous method of pain relief and their satisfaction with it. Patients were also asked to estimate the total cost of PCA (0-$50, $50-100, $100-200, >$200), and what amount if any they would be willing to pay (0-$50, $50-100, $100-200, >$200). Results obtained over a recent four month period were reviewed, Results: One hundred and thirty-three quesbonnaires were distributed and 103 (77%) were returned. The percentage of patients rating their satisfaction as very good or excellent was 86% for pain relief. 96% for followup, 71% for side effect treatment, but only 43% for their previous surgical pain relief (P <0.001 ). The distribution of cost estimates was 10% $50-100, 37% $100-200 and 53% >$200 with 60% willing to pay a portion of this cost. Those willing to pay were more likely to have had very good or excellent pain relief (94% vs 71%, P <0.05) and treatment of side effects (71% vs 48%, P <0.05) than those not willing to pay. Conclusions: Patients continue to be highly satisfied with PCA therapy and are aware of the costs involved. A majority of patients were willing to pay to obtain this service if necessary. Patients who had poorer pain relief and less efficacious treatment of their side effects were less willing to pay.Objectif : Pr&iser les connaissances et les attitudes du patient ~ I'Egard des coOts de I'auto-analgEsie (PCA) procurEe par un service de gestion de la douleur aiguE en fonctton du programme d'assurance-qualitE. M&hodes : Des questionnaires pertinents ~ I'assurance-qualitE ont EtE distribu& ~ tousles patients recevant un morphinique en PCA pour plus de 12 h. Les patients devaient y noter I'existence d'effets secondaires (nausEes, vomissements, prurit, retention urinaire), le degre de satisfaction quant au soulagement, au suivi, au traitement des effets secondaires et comparer la mEthode ant&ieure de traitement de la douleur et le degre de satisfaction obtenu avec celle-ci. On leur demandait aussi d'Evaluer le coot total de la PCA (0-505, 50-1005, 100-2005, >2005) et le montant qu'ils seraient prCts ~ payer (0-505, 50-1005, 100--2005, >2005) Eventuellement pour ce service. Cette &ude visait une penode rEcente de quatre mois.R~sultats : Cent trente-trois questionnaires ont EtE distribu& dont 103 (77%) sont revenus complEtEs. Le pourcentage de patients dont le degrE de satisfaction Etait jug~ de tr& grand ~ excellent Etait de 86% pour le soulagement de la douleur, 96% pour le suivi, 71% pour le traitement des effets secondair...

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“…1 However, only few studies have evaluated the efficacy of low bolus doses of opioid. 4 5 In this study piritramide was chosen as the opioid for PCA.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, in numerous studies it was shown clearly that PCA allows optimum individual titration of analgesia and enhances patient satisfaction with postoperative pain management. 1 However, sedation and nausea are still the most frequent side effects during PCA with opioids. Theoretically, reducing the opioid dose could reduce side effects, but may also lead to insufficient pain relief.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Influence of bolus size on efficacy of postoperative patient-controlled analgesia with piritramide

Morlion¹,

Ebner²,

Weber³

et al. 1999

British Journal of Anaesthesia

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We have examined the influence of bolus size on efficacy, opioid consumption, side effects and patient satisfaction during i.v. patient-controlled analgesia (PCA) in 60 patients (ASA I-II, aged 32-82 yr) after abdominal surgery. Patients were allocated randomly, in a double-blind manner, to receive PCA with a bolus dose of either piritramide 0.75 mg or 1.5 mg (lockout 5 min) for postoperative pain control. Mean 24 h piritramide consumption differed significantly between groups (11.4 (SD 5.8) mg vs 22.5 (18.3) mg; Pϭ0.001). There were no significant differences in the number of applied bolus doses, pain scores, pain relief (VAS), sedation, nausea, pruritus and patient satisfaction. We conclude that a PCA regimen with a bolus dose of piritramide 0.75 mg and a lockout time of 5 min was effective in the treatment of postoperative pain, but did not reduce the occurrence of side effects.Br J Anaesth 1999; 82: 52-5

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Postoperative patient-controlled analgesia: Meta-analyses of initial randomized control trials

Cited by 377 publications

References 20 publications

Is sciatic nerve block advantageous when combined with femoral nerve block for postoperative analgesia following total knee arthroplasty? a meta-analysis

Is sciatic nerve block advantageous when combined with femoral nerve block for postoperative analgesia following total knee arthroplasty? a meta-analysis

Patient attitudes regarding pca and associated costs

Influence of bolus size on efficacy of postoperative patient-controlled analgesia with piritramide

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