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Patient-controlled analgesia for postcholecystectomy pain: a pilot study
L Gonsalves1, E C Covington, T Broughan
1Section of Liaison Psychiatry, Cleveland Clinic Foundation, Ohio 44195.
Abstract:
Patient-controlled analgesia (PCA) is designed to avoid both excessive and inadequate analgesia in postoperative pain by allowing the patient self-administration of intravenous narcotics within a range of parameters established by the physician. Of 24 patients undergoing elective cholecystectomy referred to our study over a 12-month period, 11 were assigned to PCA and eight successfully completed the study. Most of them had good analgesia, were satisfied with PCA, and had no evidence of confusion, psychic distress, or visual-motor impairment. Serum morphine concentrations of 10-30 ng/mL were sufficient to obtain good analgesia in six of eight patients. Complications included severe respiratory depression and abdominal cramps.