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Patient-controlled intranasal diamorphine for postoperative pain: an acceptability study
A Hallett1, F O'Higgins, V Francis
11 Senior House Officer, 2 Registrar and 3 Consultant, Department of Anaesthesia, Royal United Hospital, Combe Park, Bath BA1 3NG, UK.
Anaesthesia
|June 24, 2000
Summary
Patient-controlled intranasal diamorphine (PCINDA) was well-tolerated by patients and nurses for postoperative pain management. This effective technique showed high satisfaction and willingness for future use, with minimal side effects.
Area of Science:
- Anesthesiology
- Pharmacology
- Pain Management
Background:
- Postoperative pain management is crucial for patient recovery.
- Existing methods like intramuscular or intravenous analgesia have limitations.
- Patient-controlled analgesia (PCA) offers tailored pain relief.
Purpose of the Study:
- To assess patient and nurse acceptability of patient-controlled intranasal diamorphine (PCINDA).
- To evaluate the efficacy and side effects of PCINDA in orthopedic and gynecological surgery patients.
- To compare PCINDA with traditional postoperative pain relief methods.
Main Methods:
- A prospective study involving patients undergoing non-emergency orthopedic or gynecological surgery.
- Patients self-administered intranasal diamorphine for 24 hours postoperatively.
- Regular assessments of pain, pain relief, sedation, respiratory rate, nausea, and vomiting were conducted.
Main Results:
- High satisfaction reported by 69% of patients and 69% of nurses.
- 45% of patients and 50% of nurses found pain relief better than expected/normal.
- 79% of patients and 89% of nurses would use/allow PCINDA again; mild sedation and no significant respiratory depression were observed.
- 53% of patients experienced no nausea and 74% did not vomit; device reliability issues led to some withdrawals.
Conclusions:
- Patient-controlled intranasal diamorphine is an effective and well-tolerated postoperative analgesia technique.
- PCINDA offers a viable alternative with high patient and nurse satisfaction.
- Further research is needed to compare PCINDA directly with intravenous and intramuscular analgesia.