Patient-controlled analgesic therapy: clinical experience.

Area of Science:

• Anesthesiology
• Pharmacology
• Surgical Patient Care

Background:

• Postoperative pain management is crucial for patient recovery.
• Intravenous patient-controlled analgesia (PCA) offers an alternative to traditional methods.
• Understanding the efficacy and safety of PCA with specific narcotic analgesics is important.

Purpose of the Study:

• To evaluate the effectiveness and patient satisfaction of self-administered intravenous narcotic analgesics for postoperative pain.
• To determine the average analgesic demand and equianalgesic ratios of commonly used narcotics.
• To assess the incidence and nature of adverse respiratory events associated with this method.

Main Methods:

• Fifty-six surgical patients received intravenous narcotic analgesics via patient-controlled analgesia (PCA).
• Analgesic consumption (morphine, pethidine, ketobemidone) was recorded hourly.
• Respiratory parameters (PaCO2) and adverse effects were monitored.

Main Results:

• Average hourly analgesic demand was 2.7 mg morphine, 26 mg pethidine, or 2.3 mg ketobemidone.
• Two hypovolemic patients experienced acute respiratory depression, which resolved with fluid correction.
• 13% of patients had short-duration late respiratory complications; drowsiness and dry mouth were most common.

Conclusions:

• Self-administered intravenous narcotic analgesia is a highly satisfactory method for postoperative pain control.
• Careful patient selection and monitoring are essential to manage potential respiratory depression, especially in hypovolemic states.
• The equianalgesic ratios observed align with established data, supporting the use of these agents in PCA.