A randomized controlled trial of patient-controlled analgesia compared with boluses of analgesia for the control of acute traumatic pain in the emergency department.
BACKGROUND
The use of patient-controlled analgesia (PCA) has been reported to provide effective pain relief, often resulting in less opioid consumption, and is associated with greater patient satisfaction when it is compared to other techniques of analgesia delivery.


OBJECTIVE
This study was done to compare the effectiveness of pain relief and patient satisfaction between PCA and the conventional method of administering boluses of analgesia for acute pain of traumatic origin in the Emergency Department (ED).


METHODS
Study patients were randomized into two groups after being given a bolus of morphine. The PCA group was then given morphine via the PCA system, whereas the control group was given the conventional boluses of morphine via titration method. Pain levels were measured using the visual analogue scale at intervals of 0, 15, 30, 45, 60, 90, and 120 min. Any adverse events were also noted. Finally, within 24 h, these patients completed questionnaires regarding their experience with regard to the pain relief they experienced.


RESULTS
The PCA group experienced faster and greater pain relief. No life-threatening events were encountered. The satisfaction questionnaire revealed that the PCA group was more satisfied using the PCA method of pain relief than those receiving standard boluses for delivery of analgesia.


CONCLUSIONS
PCA provides more effective pain relief and more patient satisfaction when compared to the conventional method of titrated bolus intravenous injection for the relief of traumatic pain in the ED setting.
Department of Emergency Medicine, Pusat Pengajian Sains Perubatan (PPSP), Universiti Sains Malaysia (USM), Kubang Kerian, Malaysia.
Nik H N A
NH
Rahman
Terence
T
DeSilva
D059787:Acute Pain / Q000188:drug therapy*; D000328:Adult; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D004636:Emergency Service, Hospital; D006801:Humans; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D059408:Pain Management; D010147:Pain Measurement; D017060:Patient Satisfaction; D014947:Wounds and Injuries / Q000150:complications*; D055815:Young Adult
D000701:Analgesics, Opioid; D009020:Morphine