Postoperative patient-controlled analgesia (PCA): How much control and How much analgesia?

Shiloh, Shoshana; Zukerman, Gil; Butin, Berta; Deutch, Anna; Yardeni, I. Z.; Benyamini, Yael; Beilin, Benzion

doi:10.1080/0877044031000148255

Cited by 9 publications

(6 citation statements)

References 64 publications

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“…Pain is one of the major concerns in the postoperative care, not only because of the suffering it causes, but also because of its potential association with the process of recovery [ 1 ]. There is a belief that the amount of pain perceived is merely directly proportional to the extent of injury [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Prediction of postoperative pain after radical prostatectomy

et al. 2008

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BackgroundThere is a belief that the amount of pain perceived is merely directly proportional to the extent of injury. The intensity of postoperative pain is however influenced by multiple factors aside from the extent of trauma. The purpose of the study was to evaluate the relationship between preoperative factors that have been shown to predict postoperative pain and the self-reports of pain intensity in a population of 155 men undergoing radical prostatectomy (RP), and also to investigate if previous pain score could predict the subsequent pain score.MethodsThe correlation between potential pain predictors and the postoperative pain experiences during three postoperative days was tested (Pitmans' test). By use of a logistic regression analysis the probability that a Visual Analogue Scale (VAS) score at one occasion would exceed 30 mm or 70 mm was studied, depending on previous VAS score, age, depression and pain treatment method.ResultsAge was found to be a predictor of VAS > 30 mm, with younger patients at higher risk for pain, and preoperative depression predicted VAS > 70 mm. The probability that VAS would exceed 30 mm and 70 mm was predicted only by previous VAS value. Day two however, patients with epidural analgesia were at higher risk for experiencing pain than patients with intrathecal or systemic opioid analgesia.ConclusionThe results show that it would be meaningful to identify RP patients at high risk for severe postoperative pain; i.e. younger and/or depressive patients who might benefit from a more aggressive therapy instituted in the very early postoperative period.

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Section: Introductionmentioning

confidence: 99%

Prediction of postoperative pain after radical prostatectomy

et al. 2008

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“…Shin et al [15] compared ultrasound guided OSTAP with conventional intravenous opioid administration for patients undergoing laparoscopic cholecystectomy using VAS scores and found that the block OSTAP reduced scale scores of verbal numerical pain postoperatively than the standard treatment at 10 min (2 [1][2][3][4] vs. 7 [5][6][7][8] The lower VAS scores found in this study compared to ours is mostly because that the open surgical approach is much more painful than laparoscopic one.…”

Section: Discussionmentioning

confidence: 50%

“…Effective pain management in the post-operative period is not only essential to alleviate suffering but pain has also been with a potential negative impact on the rate and success of recovery, which in turn affects hospital stay duration and hospital costs [1]. Postoperative pain following abdominal surgery if severe enough may cause several side effects as ''splinting, hypoventilation, atelectasis, immobility, hypercoagulability, thromboembolic events, vasoconstriction, tachycardia, increased systemic vascular resistance, dysrhythmias and cardiac ischemia in susceptible patients, insomnia, anxiety, feeling of helplessness" [2].…”

Section: Introductionmentioning

confidence: 99%

A comparison of oblique subcostal transversus abdominis plane block versus thoracic paravertebral block for postoperative analgesia after open cholecystectomy

Kamhawy

El-Taher

Abdelrahman

2017

Egyptian Journal of Anaesthesia

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“…Likely, this extends to the patients' view of the therapeutic alliance as well. Patients are not as willing to adhere to their medical regimen when they are not given an opportunity to actively participate in decision making [15][16][17]. Patient Controlled Anesthesia (self-administering of pain medications) illustrates the phenomenon.…”

Section: Patient-centered Variablesmentioning

confidence: 99%

“…Patients allowed control over their medication administration and dosages are less likely to use or overuse medications as compared to patients whose medication is regulated by a physician or nurse [18]. It is well established that patients offered a collaborative role in decisionmaking are more likely to conform to medical recommendations and treatment regimens [16].…”

Section: Patient-centered Variablesmentioning

confidence: 99%

Medication Adherence:An Important Uncontrolled Variable in Clinical Trials

Griswold¹,

Murray²,

Corrado³

2012

Adv Pharmacoepidem Drug Safety

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Over the past decade, there have been thousands of controlled clinical trials assessing the efficacy and safety of drugs used to treat a range of illnesses. The purpose of this review is to document how often medication adherence is controlled in pharmaceutical drug research. Authors of this study focused specifically on psychiatric drugs and clinical drug trials between the years 2002 and 2012. The automated searches included the use of search engines designed to scan documents for key words; limiters were set to narrow the search queries to human subjects, clinical drug trials, and publications within the past 10 years (2002 to 2012). Databases reviewed included: PubMed / Medline, Science Direct, Scirus, and Scopus. The variable, control for adherence, occurred in a low frequency among articles published, and statistical significance was found between drug classes as well as queried search phrases that examined adherence versus compliance. Overall, mention of control for adherence or compliance is missing in a significant and large portion of published articles involving clinical drug trials. The results revealed that the majority of articles written, across all four databases and all seven drug categories, did not control for medication adherence and compliance. At the conservative end, results show that approximately 67% of articles on clinical drug trials neglected to mention or control for compliance. Results call into question the validity of clinical drug trial claims, as well as the safety and efficacy of pharmaceuticals in psychiatric practice.

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Postoperative patient-controlled analgesia (PCA): How much control and How much analgesia?

Cited by 9 publications

References 64 publications

Prediction of postoperative pain after radical prostatectomy

Prediction of postoperative pain after radical prostatectomy

A comparison of oblique subcostal transversus abdominis plane block versus thoracic paravertebral block for postoperative analgesia after open cholecystectomy

Medication Adherence:An Important Uncontrolled Variable in Clinical Trials

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