Abstract
Acute and severe pain is frequent in patients who undergo cardiothoracic surgery. Patient controlled analgesia (PCA) can be used to manage postoperative pain. 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. 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. 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. 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.
Highlights
Acute and severe pain is frequent in patients who undergo heart surgery and patient controlled analgesia (PCA) can be used to manage postoperative pain
The same efficacy of analgesia and the less morphine consumption suggest that PCA without continuous infusion of morphine seems to be better option for postoperative pain manage in heart surgery
Data were prospectively collected on patients who were in the cardiac surgery postoperative period at the intensive care unit
Summary
Acute and severe pain is frequent in patients who undergo heart surgery and patient controlled analgesia (PCA) can be used to manage postoperative pain. Objective: To compare analgesia using PCA without continous infusion with PCA plus a continuous infusion of morphine on postoperative period of heart surgery and to assess pain scores, morphine consumption, number of demand, patient satisfaction and side effects. Methods: Randomized clinical trial was performed to assess patients who had undergone heart surgery who received either PCA with and without intravenous infusion of morphine. PCA was started at extubation in both regiments according to randomization. Morphine consumption, number of demand, satisfaction and side effects were assessed at zero, six, twelve, eighteen, twenty four and thirty hours after patients’ extubation. PCA reduced level of pain with few side effects and promoted patient satisfaction [1,2,3,4]
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