Patient-controlled analgesia in gynecologic oncology

Patient-controlled analgesia (PCA) is currently being evaluated as an alternative to prn intramuscular injections for the relief of postoperative pain in patients with gynecologic malignancies. From June 1985 to May 1986, twenty patients undergoing abdominal hysterectomy received PCA rather than traditional intramuscular injections for relief of postoperative pain. PCA was administered by a lightweight, wearable, disposable system, the Travenol Infuser with Patient Control Module. The PCA device delivered a 1-mg intermittent intravenous injection of morphine upon patient demand with a delay of 6 min between allowable administrations. The mean amount of morphine utilized postoperatively by the PCA patients (66 mg over 48 hr) was not significantly different from the amount used by a control group receiving prn im morphine injections. No cases of respiratory or cardiac depression were observed, and patients were generally alert throughout the period of analgesia. These data suggest that PCA is a safe and effective mode of analgesia administration. In addition, the unique characteristics of this new compact device were well accepted.