[Introduction of patient-controlled analgesia--an interim report]

In spite of improved therapeutic methods, the number of patients who suffer from moderate or severe postoperative pain remains high at 30 to 70%. It is accepted that improvement of the organization of postoperative pain therapy is a necessary precondition for changing this situation. Therefore, patient-controlled analgesia (PCA) using pain-pumps should be recognized and the effect on the whole postoperative pain therapy of a university clinic observed. The authors report on the introduction of general therapeutic guidelines for the use of patient-controlled pain-pumps. The recovery ward takes on a central role for both the beginning of pain therapy and the further care of the patient in various peripheral wards. It proved to be advantageous to use a bed-side protocol to document the programming of the pain-pumps and to register the pain-scores and side-effects. Because of these fundamental changes, the frequency of the application of pain-pumps increased six-fold within one year. Additionally, rapid pain treatment based on patients' needs increased clearly from 9.2 to 30.8%. The standardized introduction of PCA had an extremely favourable effect on the whole postoperative pain therapy and can thus be wholeheartedly recommended.