PubMed · 8105715
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P J Youngs. 1993. A problem with a PCA pump.. https://doi.org/10.1111/j.1365-2044.1993.tb07620.x
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Intrathecal administration of an opioid such as morphine in combination with a local anaesthetic such as bupivacaine is an effective treatment for severe cancer pain. The treatment, which can often be made available in the patient's home, provides relief from pain without unwanted sedation, when high-dose oral or parenteral morphine no longer has any effect. The patient controls the treatment, and can achieve a balance between pain relief and side-effects. The article outlines the routines established at the pain unit at Sahlgrenska Hospital in Gothenburg.
The purpose of the study was to evaluate the efficiency of patient-controlled analgesia (PCA) combined with continuous epidural block in patients who underwent lumbar spine surgery. In group 1 (postoperative PCA group), 23 patients were administered postoperative continuous epidural block in combination with analgesics, which was self-regulated by the patient using a device. In contrast, the 22 patients in group 2 (control group) received suppositories or intramuscular injections of analgesics on request. The following factors were compared between the two groups: pain relief according to the visual analog scale for pain assessment, the frequency of administration of analgesics, and side effects of the postoperative analgesia. The patients in group 1 had more satisfactory relief of pain according to the visual analog scale for pain assessment and needed suppositories and intramuscular injection of analgesics less frequently on the 1st, 2nd, and 3rd postoperative day. The time spent by nurses on pain management in group 1 was less than that in group 2. No patient had any serious complications in either group. In conclusion, the present patient-controlled method combined with postoperative continuous epidural block could decrease the intensity of postoperative pain and the amount of time spent by nurses on the administration of postoperative analgesics after lumbar spine surgery.
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