Comparison of satisfaction and pain relief between patients-controlled analgesia and interval analgesia after laparoscopic ovarian cystectomy

Abstract

Preoperative and postoperative psychological factors, postoperative pain, analgesic consumption, treatment satisfaction were compared in patients treated with intravenous patient-controlled analgesia (IV-PCA) or intramuscular analgesics after laparoscopic ovarian cystectomy. Thirty-one women with laparoscopically operated benign ovarian cysts were recruited in Zonguldak Karaelmas University Faculty of Medicine, Department of Obstetrics and Gynecology. Postoperatively sixteen women received morphine delivered by IV-PCA pump system and 15 women were prescribed another opioid (meperidine) intramuscularly. Two weeks before and one day after the surgery, Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were self-administered. Afterwards, the operation visual analog scale (VAS) and satisfaction with pain control scale were recorded. Preoperative BDI and BAI scores of both groups were comparable. Postoperative BDI (7.9 ± 7.2 versus 13.8 ± 6.9, P = 0.03) and BAI (11.4 ± 9.1 versus 17.4 ± 6.2, P = 0.045) scores were significantly lower in the IV-PCA group. Morphine usage with PCA resulted in significantly higher pain scores than equivalent doses of meperidine administered intramuscularly (2.94 ± 1.0 versus 1.67 ± 0.7, P = 0.001). Although higher pain scores were obtained from IV-PCA group, self-reported satisfaction rates were higher in this group (8.3 ± 1.1 versus 7.4 ± 1.1, P = 0.04). Involvement of patients in their pain management might increase the awareness of pain but their satisfaction about the control of postoperative pain was significantly improved.