[Postoperative analgesia using the intravenous PCA technique. Results in the first 400 patients treated at a general hospital].
BACKGROUND
PCA (patient controlled analgesia) has represented a remarkable advance in the treatment of postoperative pain. In this work we describe our experience with this analgesic technique.


METHODS
One hundred patients undergoing thoracic and abdominal surgery were selected after giving information to the medical and nurse personnel. Pharmacologic agents used in this study were morphine (intravenous PCA) and fentanyl (epidural PCA). Starting of the perfusion pump was done by the anesthesiologist at the Recovery Unit and the treatment was continued by the nurse. Every morning the patients were visited and the degree of analgesia was recorded according to the following score: 1: no pain, and 5: intolerable pain. An anesthesiologist was permanently available. Later on, this study was expanded to 400 patients including other types of surgery.


RESULTS
Mean duration of the treatment was 60 hours. The amount of analgesics administered varied among patients and was greater during the first postoperative hours specially in the group of patients treated with fentanyl. The mean degree of pain was 1.5 (grade 1 in 37.5% of cases and grade 5 in 3.5% of patients). Secondary effects were only nausea and vomiting. Inconvenient features of the technique were: patient's difficulties in the management of the technique (3 cases), and spontaneous loss of the program (1 case). Patient's acceptance of the technique was good.


CONCLUSIONS
PCA analgesia has been successfully introduced in our hospital since it is effective, safe, easy to manage.
Blanco
E
E
Servicio de Anestesiología y Reanimación, Hospital General de Galicia, La Coruña.
Blanco
J
J
Pedraza
I
I
Alvarez
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015360:Analgesia, Epidural / Q000295:instrumentation / Q000379:methods*; D016058:Analgesia, Patient-Controlled; D002648:Child; D005069:Evaluation Studies as Topic; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006769:Hospitals, General; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000188:drug therapy*; D010342:Patient Acceptance of Health Care; D012189:Retrospective Studies; D013030:Spain
D009020:Morphine; D005283:Fentanyl
Analgesia postoperatoria con técnica de PCA intravenosa. Resultados en los 400 primeros pacientes tratados en un hospital general.