How effective is patient-controlled analgesia? A randomized comparison of two protocols for pain relief during oocyte recovery.
Although the conventional method of pain relief during outpatient oocyte recovery involves physician-administered drugs, patient-controlled analgesia (PCA) offers an alternative technique with the potential to give women more control over peroperative analgesia. We conducted a prospective randomized study to compare the effect of fentanyl administered either through a PCA delivery system or by a physician. Thirty-nine women were randomized to PCA during egg collection while 42 were allocated to receive intermittent doses administered by a physician. Pain was evaluated by means of a 100 mm linear analogue scale. The mean (SD) pain score in the PCA group was 38.5 (19.8) while in the other group it was 46.1 (21.3) (P = 0.1). In the PCA group, 64% of women felt very satisfied with their analgesia as compared with 57% in the non-PCA group (P = 0.6). Among the PCA users, 39% of demands were successful. Significantly more fentanyl (97.5 microg) was used in the PCA group than in the other group (84.6 microg) (P = 0.03). Though intraoperative PCA with fentanyl is an effective alternative to physician-administered techniques, many women still feel the need for more analgesia during the procedure.
Bhattacharya
S
S
University Department of Obstetrics and Gynaecology, Aberdeen Maternity Hospital, UK.
MacLennan
F
F
Hamilton
M P
MP
Templeton
A
A
D000328:Adult; D000556:Ambulatory Surgical Procedures; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D005307:Fertilization in Vitro; D006801:Humans; D007246:Infertility / Q000628:therapy; D009865:Oocytes; D011446:Prospective Studies
D000701:Analgesics, Opioid; D005283:Fentanyl