Preoperative education and outcome of patient controlled analgesia.
OBJECTIVE
To determine the effect of intensive preoperative education on the outcome of Patient Controlled Analgesia (PCA) postoperatively.


METHODS
This prospective randomised study was carried out in a single teaching hospital over three months. One group of patients (n = 42) received a 20 min standardised tutorial regarding PCA use from a single investigator and the other group (n = 43) received no additional education apart from the routine preoperative anaesthetic consultation. A blinded investigator assessed the patients following surgery. Pain scores and morphine consumption, patient satisfaction, side-effect profile and anti-emetic use were recorded at six, 24 and 48 hr postoperatively.


RESULTS
Pain scores, satisfaction scores and morphine consumption were similar in both groups throughout the study period. Fewer patients in the tutored group complained of nausea from 6 to 24 hr than did untutored patients (28% vs 51%; P < 0.05). More tutored patients used antiemetic medication from 0 to 6 (28% vs 12%; P < 0.05) and 6 to 24 hr (37% vs 19%; P < 0.05). Side effect profile and requirement for rescue analgesia was otherwise similar in both groups.


CONCLUSIONS
Our results suggest that specific preoperative education of patients using PCA does not alter pain scores, morphine consumption or patient satisfaction but may result in earlier and more effective use of anti-emetic medication.
Griffin
M J
MJ
Department of Anaesthesia and Intensive Care, St. Vincent's Hospital, Dublin, Ireland. michael.griffin@yale.edu
Brennan
L
L
McShane
A J
AJ
D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control; D011300:Preoperative Care; D011446:Prospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D000932:Antiemetics; D009020:Morphine