An investigation of the current literature on the effectiveness of patient-controlled analgesia methods.
The purpose of this investigation was to determine, through current research in the literature, if a background basal infusion should routinely be used to improve the efficacy of traditional-demand patient-controlled analgesia (PCA) and would the safety of the PCA technique be maintained with the addition of a continuous infusion. Of the nine studies investigating PCA with and without continuous infusion, six found no improvement in pain control with the addition of a continuous infusion. The patients receiving continuous infusion did not make fewer demands than the control group, nor did they report lower pain scores. The addition of a continuous background infusion to PCA diminishes the inherent safety of the PCA modality of pain management. Many studies reported an increased incidence of side effects with the addition of a continuous infusion. This modality of PCA should be reserved for use in patients in whom traditional-demand PCA does not satisfy analgesic requirements.
Cokefair
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A
Smith
H S
HS
Gries
C A
CA
D016058:Analgesia, Patient-Controlled / Q000009:adverse effects / Q000379:methods* / Q000451:nursing; D002986:Clinical Trials as Topic; D006801:Humans; D010147:Pain Measurement; D016896:Treatment Outcome