The Efficacy of Patient-Controlled Analgesia

The practice of patient managed analgesia (PCA) has existed for about 40 years. Meanwhile, this technology has advanced and the use of this type of patient's pain management has improved, but there are still problems related to the safety and effectiveness of PCA. As the analysis progresses, briefly explain what and how PCA is using, then explain in detail the benefits and safety issues of PCA's use in relation to patients and nurses.

Patient Control Analgesia (PCA) is a common way of postoperative analgesia with devices with syringes, pumps, and timing mechanisms. It works by pushing the patient's button to accommodate individual pain levels, by supplying a small amount of analgesic called bolus administration to the patient's venous line (Pudner 2010). The PCA system is an effective analgesic method to reduce the risk of serious complications after surgery (King and Walsh 2007). Rawal (1999) showed that it provides more pain management than traditional oral, intramuscular (IM) and intravenous methods, as it provides a controlled uninterrupted analgesic. However, Bandier (2004) showed that there was little difference in pain experience during the first 24 hours between patients treated with analgesics with IM injection and patients with PCA. On the contrary, PCA seems to be more beneficial after 48 hours.

The time to rescue analgesics for the first time, the number of patients receiving emergency analgesics, and the dose of emergency analgesics are usually the results of analysis of postoperative pain. The time to rescue analgesics for the first time is a clinically important result but it is problematic if it is used to compare procedures that are less painful and if many patients do not need to rescue analgesics Seems like. A censored patient (ie, a patient who does not need emergency treatment) may introduce a bias. Therefore, other statistical methods such as Kaplan-Meier curves analysis and risk ratio calculation are considered to be suitable for analysis of analgesia period.

Effect of addition of magnesium on local anesthetic anesthesia for postoperative pain in pediatric surgery patients: meta-analysis of sequential analysis of systematic review and test

Electrical stimulation of the posterior column of the spinal cord provides analgesic effect. First, the lead was guided by fluoroscopy and feedback from the patient, and the generator was externally worn for several days to evaluate effectiveness. If pain is reduced more than half, the treatment is considered appropriate. Cut a small pocket into the tissue under the buttocks, chest wall, or abdominal skin and pass it through a pocket attached to a generator that fits the wire tightly from the irritant to the underside of the skin. It seems to be more useful than nociceptive pain due to neuropathy and ischemic pain, but current evidence is too weak to recommend it for the treatment of cancer pain