title: Comparison study of two different patient-controlled anesthesia regiments after cardiac surgery.
abstract: BACKGROUND
  Acute and severe pain is frequent in patients who undergo cardiothoracic surgery. Patient controlled analgesia (PCA) can be used to manage postoperative pain.
  
  
  OBJECTIVE
  To compare analgesia of morphine PCA alone without continuous infusion with morphine PCA plus a continuous infusion on postoperative period after cardiac surgery and to evaluate pain scores, morphine consumption, number of demand, patient satisfaction and side effects.
  
  
  METHODS
  Randomized trial was conducted to assess patients who underwent cardiac surgery receiving either morphine PCA alone or morphine PCA plus continuous infusion. In the post operative period, PCA was started at extubation in both regiments according to randomization. Pain intensity, morphine consumption, number of demand, satisfaction and side effects were assessed at zero, six, twelve, eighteen, twenty four and thirty hours after patients' extubation.
  
  
  RESULTS
  The study enrolled 100 patients. 50 patients received morphine PCA alone, (Group A) and 50 patients received morphine PCA plus a background infusion, (Group B). Group B patients had less demand, consumed more morphine and were more satisfied regarding analgesia. No statistical differences were shown between groups related to pain intensity, and side effects.
  
  
  CONCLUSIONS
  Pain control was effective and similar in both groups. Morphine PCA alone seems to be better for postoperative pain manage in cardiac surgery, due to its less morphine expense with the same effectiveness.
authors.affiliation: Heart Institute and Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Fabiane Almeida
authors.initials: FA
authors.lastname: Mota
authors.forename: João Fernando
authors.initials: JF
authors.lastname: Marcolan
authors.forename: Mara Helena Corso
authors.initials: MH
authors.lastname: Pereira
authors.forename: Adriano Márcio de Melo
authors.initials: AM
authors.lastname: Milanez
authors.forename: Luis Alberto Oliveira
authors.initials: LA
authors.lastname: Dallan
authors.forename: Solange
authors.initials: S
authors.lastname: Diccini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000704:Analysis of Variance; D006348:Cardiac Surgical Procedures; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010146:Pain / Q000503:physiopathology; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine