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Clin Shoulder Elbow > Volume 18(4); 2015 > Article
Clinics in Shoulder and Elbow 2015;18(4):237-241.
DOI: https://doi.org/10.5397/cise.2015.18.4.237    Published online December 31, 2015.
An Analysis on the Effect of Patient-controlled Analgesia Performed by Orthopaedic Department or Postoperative Pain Control after Shoulder and Elbow Surgery
Jae Kwang Yum, Jin Hyok Kim, Kyung Hwan Boo, Soo Hyung Ahn
Department of Orthopedic Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea. bkh26@hanmail.net
Received: 7 September 2015   • Revised: 28 November 2015   • Accepted: 4 December 2015
Abstract
BACKGROUND: We investigated the effectiveness of pain management and the adverse events of intravenous (IV) patient-controlled analgesia (PCA) after orthopedic surgery.
METHODS
From September 2014 and August 2015, we performed a retrospective analysis of 77 patients who underwent orthopedic surgery of the shoulder or the elbow in our hospital. The composition of the intravenous PCA administered to the patients was as follows: 250 mg of dexketoprofen trametamol, 70 mg of oxycodone, and 0.6 mg of ramosetron, which were made up to 79 ml of normal saline. We evaluated and statistically analyzed the difference in the visual analogue scale (VAS) scores for pain at immediate postoperation, at 24 hours of PCA, at 72 hours of PCA, and after discontinuation of PCA and in the incidence of adverse events.
RESULTS
We found that VAS score decreased for 3 postoperative days and that with discontinuation of IV PCA a meaningful change in VAS score was no longer seen. Of the 77 patients, 22 presented with adverse events (28.6%). We terminated IV PCA temporarily in the 21 patients who presented with adverse events; we terminated analgesia permanently in one patient (1.2%). Consequently, 76 of 77 patients carried out IV PCA till the designated period.
CONCLUSIONS
Intravenous PCA after orthopedic surgery of the shoulder or the elbow may be accompanied with adverse events. Careful assessment of the patient and treatment of the adverse outcomes are key to a successful maintenance of PCA and to a successful management of postoperative pain.
Key Words: Patient-controlled analgesia; Non-steroidal anti-inflammatory agents; Oxycodone; Ramosetron; Pain measurement
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