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Patient controlled analgesia and GI dysfunction.

K A Teter, G Viellion, E M Keating

    Orthopedic Nursing
    |July 1, 1990
    PubMed
    Summary
    This summary is machine-generated.

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    Gastrointestinal side effects from morphine, meperidine, and nalbuphine were compared in 300 joint replacement patients. No significant differences in GI dysfunction were found, highlighting the need for ongoing nursing assessment post-surgery.

    Area of Science:

    • Anesthesiology
    • Gastroenterology
    • Nursing

    Background:

    • Patient-controlled analgesia (PCA) is commonly used for postoperative pain management.
    • Opioid analgesics, including morphine, meperidine, and nalbuphine, can cause gastrointestinal (GI) dysfunction.
    • Understanding the comparative GI side effects of different PCA narcotics is crucial for patient care.

    Purpose of the Study:

    • To compare the incidence and severity of gastrointestinal side effects among morphine, meperidine, and nalbuphine when administered via patient-controlled analgesia (PCA).
    • To evaluate the reliability of initial postoperative GI assessments in predicting sustained normal GI function.

    Main Methods:

    • A prospective randomized study involving 300 patients undergoing total joint replacement surgery.

    Related Experiment Videos

  • Patients received analgesia via PCA using one of three narcotics: morphine, meperidine, or nalbuphine.
  • Gastrointestinal side effects were systematically monitored and compared across the three treatment groups.

    • Main Results:

    • All patient groups experienced some form of GI dysfunction post-surgery.
    • There was no statistically significant difference in the prevalence or type of GI dysfunction among the morphine, meperidine, and nalbuphine groups.
    • Initial normal GI assessment in the early postoperative period did not reliably predict the absence of future GI issues.

    Conclusions:

    • The choice of opioid (morphine, meperidine, or nalbuphine) for PCA in total joint replacement patients did not significantly alter the risk of gastrointestinal side effects.
    • Extended nursing assessment of gastrointestinal status is essential for postoperative patients receiving PCA, as initial assessments may not capture the full course of GI dysfunction.