Introducing a patient-controlled analgesia-based acute pain relief service into southern Africa--the first 10 months

The 10 months after the introduction of the first acute pain relief service (APRS) in southern Africa is described. Seven hundred patients were treated with morphine by means of patient-controlled analgesia (PCA), administered to patients after major surgery or extensive burns via the intravenous (IV) or subcutaneous (SC) route. The efficacy, safety and resource implications were assessed. The results showed that pain control was good, with the majority of patients (66%) experiencing mild pain during the first 24 hours. The pump was used by each patient for an average of 4.32 days. The mean total dose of morphine used was 105.2 mg via the IV route and 114.6 mg via the SC route. Over the 10 months, the 25 PCA pumps worked 80,000 pump-hours; only 3 pumps malfunctioned. A total of 86,861 mg morphine was used during this period with rare morbidity and no mortality. Only 1 patient experienced sedation and respiratory depression. The benefits of an APRS with PCA to patients and medical staff alike are discussed.