Comparison study of two different patient-controlled anesthesia regiments after cardiac surgery.
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.
Mota
Fabiane Almeida
FA
Heart Institute and Federal University of São Paulo, São Paulo, SP, Brazil.
Marcolan
João Fernando
JF
Pereira
Mara Helena Corso
MH
Milanez
Adriano Márcio de Melo
AM
Dallan
Luis Alberto Oliveira
LA
Diccini
Solange
S
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
D000701:Analgesics, Opioid; D009020:Morphine