The evaluation of implementing smart patient controlled analgesic pump with a different infusion rate for different time duration on postoperative pain management

Abstract

BackgroundControl of postoperative pain is an important aspect of postoperative patient management. Among the methods of postoperative pain control, patient-controlled analgesia (PCA) has been the most commonly used. This study tested the convenience and safety of a PCA method in which the dose adjusted according to time.MethodsThis study included 100 patients who had previously undergone orthognathic surgery, discectomy, or total hip arthroplasty, and wished to control their postoperative pain through PCA. In the test group (n = 50), the rate of infusion was changed over time, while in the control group (n = 50), drugs were administered at a fixed rate. Patients' pain scores on the visual analogue scale, number of rescue analgesic infusions, side effects, and patients' satisfaction with analgesia were compared between the two groups.ResultsThe patients and controls were matched for age, gender, height, weight, and body mass index. No significant difference in the mount of drug administered was found between the test and control groups at 0-24 h after the operation; however, a significant difference was observed at 24-48 h after the operation between the two groups. No difference was found in the postoperative pain score, number of side effects, and patient satisfaction between the two groups.ConclusionsPatient-controlled anesthesia administered at changing rates of infusion has similar numbers of side effects as infusion performed at a fixed rate; however, the former allows for efficient and safe management of postoperative pain even in small doses.

Continuous Fentanyl Background Infusion Regimen Optimised by Patient-Controlled Analgesia for Acute Postoperative Pain Management: A Randomised Controlled Trial

“…In this study, the predicted C eff of fentanyl was lower than 2.0 ng/mL in all patients, and no patient showed respiratory depression. Previous studies showed no differences in side effects between conventional CRBI and TDBI [15,30]. However, itching and dizziness were less frequent in TDBI and POBI groups possibly due to the lower total infused fentanyl dose for 24 h post-surgery (Table 2) [26,32].…”

“…Therefore, TDBI using this device could meet the initial therapeutic range for analgesia and reduce the accumulation of fentanyl over time. Furthermore, other studies have shown that the fentanyl or morphine PCA with TDBI provided more effective analgesia without increasing side effects compared to CRBI [15,30].…”

Orthognathic surgery: doubts from patients with orofacial fissures regarding the immediate postoperative period

“…The pain is related to the surgical act itself and several factors, such as contraction of peripheral soft tissues and surrounding muscle stiffness (26) . Its control improves respiratory function, promotes hemodynamic stability, inhibits hormonal and metabolic reactions, and decreases hospitalization time (27) . Assessing facial sensitivity in the postoperative period, especially in the chin, lower lip, and cheek should also be emphasized, as there may be an injury in the lower alveolar nerve during the surgical procedure (28) .…”