A retrospective investigation of the patient-controlled analgesia methods applied for postoperative pain management

Abstract

Objectives: Patient-controlled analgesia (PCA) in post­operative pain treatment is more effective than conven­tional analgesia methods. It is commonly preferred for the reasons of maintaining high patient satisfaction and posi­tive effects on patients’ recovery period with less sedation and postoperative complications. In this study we aimed to investigate the characteristics of PCA methods that have been applied at our clinic within the last two-year period retrospectively. Methods: The records of patients who were received PCA for postoperative analgesia at our hospital between 01 January 2010 and 31 December 2011 were investigat­ed. Patients’ genders, PCA protocols and the operations’ characteristics were evaluated. Results: In this study, it was seen that of the 1030 pa­tients, IV tramadol PCA was applied to 580 (56.3%) pa­tients, epidural PCA was applied to 431 (41.8%) patients and IV morphine PCA was applied to 19 (1.8%) patients. In 2011, it was seen that of the 971 patients, IV tramadol PCA was applied to 737 (75.9%) patients and epidural PCA was applied to 234 (24.1%) patients. When com­pared to 2010, it was detected that IV tramadol PCA use has significantly increased (p<0,001), whereas PCEA and IV morphine PCA uses were significantly decreased in 2011 (p<0,001 and p<0,001). In both 2010 and 2011, it was detected that PCA was applied most frequently to orthopedic surgery patients while the majority of these surgeries were lower extremity and vertebra surgeries, consequently. Conclusions: The results of this retrospective study showed that the number of PCA uses has increased over the time. In our clinic, IV PCA was used more frequently than epidural PCA while the majority of the patients whom PCA was applied was orthopedic surgery patients.