Study to Improve the Quality of Post Operative IV PCA

Parte, Kwan Sik; Park, Jong Cook; Kim, Kwang Sig

doi:2005.3.2.17

J Med Life Sci > Volume 3(2); 2005 > Article

Original Article

Journal of Medicine and Life Science 2005;3(2):17-23.
DOI: https://doi.org/10.22730/jmls.2005.3.2.17 Published online December 31, 2005.

수술 후 정맥용 자가 통증조절장치의 효과를 높이기 위한 연구

박관식¹, 박종국¹, 김광식²

¹제주대학교 의과대학 마취통증의학교실
²제주대학교 의과대학 외과학교실

Study to Improve the Quality of Post Operative IV PCA

Kwan Sik Parte¹, Jong Cook Park¹, Kwang Sig Kim²

¹Department of Anesthesiology & Pain Medicine College of Medicine, Cheju National University, Jeju 690-756, Korea
²Department of General Surgery, College of Medicine, Cheju National University, Jeju 690-756, Korea

Correspondence: Jong Cook Park, Email: pjcook@cheju.ac.kr

Abstract

Background
Uncontrolled postoperative pain not only delays postoperative recovery, but also leads to fatal cardiopulmonary complication. The postoperative intravenous patient controlled analgesia (IV PCA) is known to effectively reduce operation-related pain and thus improve postoperative recovery. We designed this study to find an effective method for improving the quality of IV PCA.
Methods
Unpremedicated 44 patients were asked by a nurse for their preoperative anxiety and wanted pain relief score with numerical rating scale (NRS) from 0 to 10. Before closure of scheduled surgery, IV PCA started with a rate of fentanyl 0.2pgm/kg, ketolorac 180ygm/kg and 15 minutes lock-out time by automatic device. Postoperative actual pain relief and satisfaction scores were asked by the same nurse with NRS score at next day. Infused total and demand volumes were also recorded three day after.
Results
Reasons of dissatisfaction were inadequate analgesia, side effects, high cost, and mechanical failure in order. Preoperative anxiety scores of female(5.78 土3.20》were higher than those of male(3.58 土 2.81Xp=0.042). There were no differences between age groups. Actual pain relief scores were well correlated with satisfaction scores especially in patients expressing inadequate analgesia as their dissatisfactory reason(r2= 0.93，p=0.001).
Conclusion
To improve the patient's satisfaction for IV PCA, rate of dose must be elevated and preoperative anxiety should be reduced with the methods such as premedication and enough explanation especially in woman.

Key Words: anxiety, intravenous patient controlled analgesia, postoperative pain