[Patient-controlled analgesia. A technical toy or a contribution to the treatment of pain?]

PCA (patient-controlled analgesia) was used to treat postoperative pain after general surgery and gynecological operations in a total of 82 patients. In a prospective randomized study, 20 of these patients received pentazocine and 20 were treated with Fentanyl. The bolus quantity for pentazocine was 15 mg in 5 ml NaCl, and that for Fentanyl 0.05 mg in 5 ml NaCl. A maximum of 3 boluses was allowed within 1 h; the refractory period was 5 min. Both drugs were equally suited for the treatment of pain. With pentazocine, an average of 144 micrograms kg-1 min-1 was administered during the first 16 h after the operation; with Fentanyl, the quantity taken was 0.78 microgram kg-1 min-1. The inter- and intraindividual variance in the consumption of analgesics described by other authors was confirmed. The amount of analgesics required ranged between 0.05 and 1.95 mg for Fentanyl and between 15 and 435 mg for pentazocine in a period of 16 h. Three patients did not request an analgesic at all. The average consumption of analgesics constantly decreased in the first few postoperative hours, from 0.28 mg every 4 h after the operation to 0.18 mg every 4 h 16 h later (Fentanyl) and from 55 mg every 4 h after the operation to 31.5 mg every 4 h 16 h later (pentazocine). The majority of patients reported very positive experience with PCA. There were few side effects. Problems arose from the negative attitude of other doctors and the nursing staff, and from some misunderstandings.(ABSTRACT TRUNCATED AT 250 WORDS)