Patient-controlled analgesia: Current concepts in acute pain management

CNS Drugs

Volumn 8, Issue 3, 1997, Pages 203-218

  Owen, Harry ^a,b   Plummer, John ^a  

^a FLINDERS UNIVERSITY   (Australia)

^b FLINDERS MEDICAL CENTRE   (Australia)

Author keywords

[No Author keywords available]

Indexed keywords

ALFENTANIL; DROPERIDOL; FENTANYL; METHADONE; METOCLOPRAMIDE; MORPHINE; ONDANSETRON; OPIATE; OPIATE RECEPTOR; OXYCODONE; PETHIDINE; TROPISETRON;

COST; DRUG EFFICACY; EPIDURAL DRUG ADMINISTRATION; HUMAN; HYPOXEMIA; INTRAGASTRIC DRUG ADMINISTRATION; INTRAMUSCULAR DRUG ADMINISTRATION; INTRATHECAL DRUG ADMINISTRATION; INTRAVENOUS DRUG ADMINISTRATION; NAUSEA; PAIN; PATIENT CONTROLLED ANALGESIA; PATIENT SATISFACTION; POSTOPERATIVE PAIN; PRIORITY JOURNAL; RESPIRATION DEPRESSION; REVIEW; SUBCUTANEOUS DRUG ADMINISTRATION; VOMITING;

EID: 0030823212     PISSN: 11727047     EISSN: None     Source Type: Journal    
DOI: 10.2165/00023210-199708030-00003     Document Type: Review

References (107)

1. Owen H, McMillan V, Rogowski D, Postoperative pain therapy: a survey of patients' expectations and their experiences. Pain 1990; 41: 303-7
2. Sechzer PH, Studies in pain with the analgesic-demand system. Anesth Analg 1971; 50: 1-10
3. Owen H, Mather LE, Rowley K. The development and clinical use of patient-controlled analgesia. Anaesth Intensive Care 1988; 16: 437-47
4. Ready LB, Oden R, Chadwick HS, et al. Development of an anesthesiology-based postoperative pain management service. Anesthesiology 1488; 68: 100-6
5. Owen H, Plummer JL, Armstrong I, et al. Variables of patient-controlled analgesia. 1: bolus size. Anaesthesia 1989; 44: 7-10
6. Austin KL, Stapleton JV, Mather LE. Relationship between blood meperidine concentrations and analgesic response: a prelimmary report. Anesthesiology 1980; 53: 460-6
7. Mather LE, Owen H, The scientific basis of patient-controlled analgesia. Anaesth Intensive Care 1988; 16: 427-47
8. Owen H, Mather LE, Runciman WB, et al. The lockout interval in patient-controlled analgesia: a rational basis for choice? Br J Anaesth 1987; 59: 1328P-9P
9. Foltin RW, Fischman MW. The cardiovascular and subjective effects of intravenous cocaine and morphine combinations in humans. J Pharmacol Exp Ther 1992; 261: 623-32
10. Zacny JP, Lichtor JL, Flemming D, et al. A dose response analysis of the subjective, psychomotor and physiological effects of intravenous morphine in healthy volunteers. J Pharmacol Exp Ther 1994; 268: 1-9
11. Hamunen K, Ventilalory effects of morphine, pethidine and methadone in children' Br J Anaesth 1993; 70: 414-8
12. Whitchead EM, O'Sullivan GM, Lloyd J, et al. A new method for rale of analgesic onset: two doses of intravenous morphine compared with placebo. Clin Pharmacol Ther 1992; 52: 197-204
13. Smythe M, Haubert K, Huffman J, et al. Comparison of three morphine regimens in postsurgical patients using patient-controlled analgesia. Ann Pharmacother 1993; 27: 691-4
14. Ginsherg B, Gil KM, Muir M, et al. The influence of lockout intervals and drug selection on patient-controlled analgesia following gynecological surgery. Pain 1995; 62: 95-100
15. De Kock M, Scholtes JL, Postoperative P.C.A. in abdominal surgery: analysis of 200 consecutive patients. Acta Anaesthesiol Belg 1991; 42: 85-91
16. Plummer JL, Owen H, Ilsley AH, et al. Morphine PCA is superior to meperidine PCA for postoperative pain. Anesth Analg 1997; 84: 794-9
17. McCoy EP, Furness G, Wright PCM, et al. Patient-controlled analgesia with and without background infusion: analgesia assessed using the demand:delivery ratio. Anaesthesia 1993; 48: 256-65
18. Doyle E, Harper I, Morton NS, Patient-controlled analgesia with low dose background infusions after lower abdominal surgery in children. Br J Anaesth 1993; 71: 818-22
19. Owen H, Szekely SM, Plummer JL, et al. Variables of patientcontrolled analgesia. 2: Concurrent infusion. Anaesthesia 1989; 44: 11-3
20. Parker RK, Holtmann B, White PF. Patient-controlled analgesia: does a concurrent opioid infusion improve pain management after surgery? JAMA 1991; 266: 1947-52
21. Baubillier E, Leppert C, Delaunay L, et al. Analgésie contrôlée par le patient: effet de l'adjonction d' une perfusion continue de morphine. Ann Fr Anesth Reanim 1992; 11: 479-83
22. Russell AW, Owen H, Ilsley AH, et al. Background infusion with patient-controlled analgesia: effect on postoperative oxyhuemoglobin saturation and pain control. Anaesth Intensive Care 1993; 21: 174-9
23. Dawson PJ, Libreri KC, Jones DJ, et al. The efficacy of adding a continuous intravenous morphine infusion to patient-controlled analgesia in abdominal surgery. Anaesth Intensive Care 1995; 23: 453-8
24. Parker RK, Holtmann B, White PF. Effects of a nighttime opioid infusion with PCA therapy on patient comfort and analgesic requirements after abdominal hysterectomy. Anesthesiology 1992; 76: 362-7
25. Harmer M, Slattery PJ, Rosen M, et al. Intramusecular on-demand analgesia: double blind controlled trial of pethidine. buprenorphine. morphine, and meptazinol. BMJ 1983; 286: 680-2
26. White PF. Subcutaneous PCA: an alternative to IV-PCA for postoperative pain management. Clin J Pain 1990; 6: 297-300
27. Doyle E, Morton NS, McNicol LR, Comparison of patient-controlled analgesia in children by i.v. and s.c. routes of administration. Br J Anaesth 1994; 72: 533-6
28. Gustafsson LL, Schildt B, Jacobsen K, Adverse effects of extradural and intrathecal opiates: report of a nationwide survey in Sweden. Br J Anaesth 1982; 54: 479-86
29. Gourlay GK, Cherry DA, Cousins MJ. Cephalad migration of morphine in CSR following lumbar epidural administration in patients with cancer pain. Pain 1985; 23: 317-26
30. Sjostrom S, Hartvig D, Tamsen A. Patient-controlled analgesia with extradural morphine or pethidine. Br J Anaesth 1988; 60: 358-66
31. Peng WL, Wu GJ, Sun WZ et al. Patient-controlled intravenous versus epidural analgesia after major joint replacement. Ma Tsui Hsueh Tsa Chi 1992; 30: 71-7
32. Asatoor AM, London DR, Milne MD, et al. The excretion of pethidine and its derivatives. Br J Pharmacol 1963; 20: 285-98
33. Kaiko RF, Foley KM, Grabinski PY, et al. Central nervous system excitatory effects of meperidine in cancer patients. Ann Neurol 1983; 13: 180-5
34. Stone PA, Macintyre PE, Jarvis DA. Norpethidine toxicity and patient controlled analgesia. Br J Anaesth 1993; 71: 738-40
35. Mitsuhata M, Matsumoto S, Hasegawa J. Intravenous patient-controlled analgesia with pethidine for the treatment of post-operative pain in patients undergoing upper abdominal surgery. Masui 1992; 41: 92-9
36. Sinatra RS, Lodge K, Sibert K, et al. A comparison of morphine, meperidine, and oxymorphone as utilized in patient-controlled analgesia following cesarean delivery. Anesthesiology 1989; 70: 585-90
37. Cade L, Ashley J, Towards optimal analgesia after caesarean section: comparison of epidural and intravenous patient-controlled opioid analgesia. Anaesth Intensive Care 1993; 21: 696-9
38. Bahar M, Rosen M, Vickers MD. Self-administered nalbuphine, morphine and pethidine: comparison by intravenous route, following cholecyslectomy. Anaesthesia 1985; 40: 529-32
39. Vetter TR. Pediatric patient-controlled analgesia with morphine versus meperidine. J Pain Symptom Manage 1992; 7: 204-8
40. Stanley G, Appadu B, Mead M, et al. Dose requirements, efficacy and side effects of morphine and pethidine delivered by patient-controlled analgesia after gynaecological surgery. Br J Anaesth 1996; 76: 484-6
41. Plummer JL, Is there still a place for pethidine in the management of postoperative pain? Curr Anaesth Crit Care 1995; 6: 98-102
42. Woodhouse A, Hobbes AFT, Mather LE, et al. A comparison of morphine, pethidine and fentanyl in the post surgical patient-controlled analgesia environment. Pain 1996; 64: 115-21
43. Howell PR, Gambling DR, Pavy T, et al. Patient-controlled analgesia following caesarean section under general anaesthesia: a comparison of fentanyl with morphine. Can J Anaesth 1995; 42: 41-5
44. Watt JWG, Soulsby NR. Fentanyl versus morphine for patient-controlled analgesia. Anaesthesia 1995; 50: 470-1
45. Grass JA. Fentanyl: clinical use as postoperative analgesic -epidural/intrathecal route. J Pain Symptom Manage 1992; 7: 419-30
46. Gourlay GK, Murphy TM, Plummer JL, et al. Pharmacokinetics of fentanyl in lumbar and cervical CSF following lumbar epidural and intravenous administration. Pain 1989; 38: 253-9
47. Loper KA, Ready LB, Downey M, et al. Epidural and intravenous fentanyl infusions are clinically equivalent after knee surgery. Anesth Analg 1990; 70: 72-5
48. Welchew FA, Breen DP. Patient-controlled on-demand epidural fentanyl: a comparison of patient-controlled on-demand fentanyl delivered epidurally or intravenously. Anaesthesia 1991; 46: 438-41
49. Grant RP, Dolman JF, Harper JA, et al. Patient-controlled lumbar epidural fentanyl compared with patient-controlled intravenous fenlanyl for post-thoracotomy pain. Can J Anaesth 1992; 39: 214-9
50. Youngstrom PC, Bulger RR. Pitfalls associated with epidural opiates [lelter]. Anesth Analg 1990; 7: 445
51. Striebel HW, Oelmann T, Spies C, et al. Patient-controlled intranasal analgesia: a method for noninvasive postoperative pain management. Anesth Analg 1996; 83: 548-51
52. Kay B. Postoperative pain relief: use of an on-demand analgesia computer (ODAC) and a comparison of the rate of use of fentanyl and allentanil. Anaesthesia 1981; 36: 949-51
53. Welchew EA, Hosking J. Patient-controlled postoperative analgesia with alfentanil: adaptive, on-demand intravenous alfentanil or pethidine compared double-blind for postoperative pain. Anaesthesia 1985; 40: 1172-7
54. Owen H, Brose WO, Plummer JL, et al. Variables of patient-controlled analgesia. 3: Test of an infusion-demand system using alfentanil. Anaesthesia 1990; 45: 452-5
55. Owen H, Currie JC, Plummer JL. Variation in the blood concentration/analgesic response relationships during patient-controlled analgesia with alfentanil. Anaesth Intensive Care 1991; 1: 555-60
56. Chauvin M, Mongnat JM, Mourgeon E, et al. Equivalence of postoperative analgesia with patient-controlled intravenous or epidural alfentanil. Anesth Analg 1993; 76: 1251-8
57. Kalso E, Vainio A, Manila MJ, et al. Morphine and oxycodone in the management of cancer pain: plasma levels determined by chemical and radioreceptor assays. Pharmacol Toxicol 1990; 67: 322-8
58. Poyhia R. Opioids in anaesthesia: a questionnaire survey in Finland. Eur J Anaesthesiol 1994; 11: 221-30
59. Kalso E, Poyhia R, Onnela P, et al. Intravenous morphine and oxycodnne for pain after abdominal surgery. Acta Anaesthesiol Scand 1991; 35: 642-6
60. Lehmann KA, Abu-Shibika M, Horrichs-Haermiger G. Post-operative Schmeraherapie mit 1-Methadon und Metamizol: eine randomisierte Untersuchung im Rahmen der intravenosen On-Demand Analgesie. Anasth Intensivther Notf Med 1990; 25: 152-9
61. Shir Y, Eimerl D, Magora F, et al. Plasma concentrations of methadone during postoperative patient-controlled extradural analgesia. Br J Anaesth 1990; 65: 204-9
62. Plummer JL, Gourlay GK, Cherry DA, et al. Estimation of methadone clearance: application in the management of cancer pain. Pain 1988; 33: 313-22
63. Sinatra R, Chung KS, Silverman DG, et al. An evaluation of morphine and oxymorphone administered via patient-controlled analgesia (PCA) or PCA plus basal infusion in post-cesarean delivery patient. Anesthesiology 1989; 71: 502-7
64. Liu S, Carpenter RL, Mulroy MF, et al. Intravenous versus epidural administration of hydromorphone: effects on analgesia and recovery after radical retropubic prostatectomy. Anesthesiology 1995; 82: 682-8
65. Searle NR, Roy M, Bergeron G, et al. Hydromorphone patient-controlled analgesia (PCA) after coronary artery bypass. Can J Anaesth 1994; 41: 198-205
66. Parker RK, White PF. Epidural patient-controlled analgesia: an alternative to intravenous patient-controlled analgesia for pain relief after cesarean delivery. Anesth Analg 1992; 75: 245-51
67. Parker RK, Sawaki Y, White PF. Epidural patient-controlled analgesia: influence of bupivacaine and hydromorphone basal infusion on pain control after cesarean delivery. Anesth Analg 1992; 75: 740-6
68. Sugai N, Yajima C, Chiuzei M, et al. Postoperative pain relief by patient controlled analgesia using intravenous pentazocine. Masui 1995; 44: 216-20
69. Ballantyne JC, Carr DB, Chalmers TC, et al. Postoperative patient-controlled analgesia: meta-analyses of initial randomized control trials. J Clin Anesth 1993; 5: 182-93
70. Koh P, Thomas VJ. Patient-controlled analgesia (PCA): does time saved by PCA improve patient satisfaction with nursing care? J Adv Nurs 1994; 20: 61-70
71. Colwell CW, Morris BA. Patient-controlled analgesia compared with intramuscular injection of analgesics for the manage- ment of pain after orthopaedic surgery. J Bone Joint Surg Am 1993; 77: 726-33
72. Sanansilp V, Lertakyamanee J, Udompunturak S. Cost-effectiveness analysis of patient-controlled analgesia, intramuscular q.i.d. injection and p.r.n. injection for postoperative pain relief. J Med Assoc Thai 1995; 11: 600-4
73. Smythe M, Loughlin K, Schad RF, et al. Patient-controlled analgesia versus intramuscular analgesic therapy. Am J Hosp Pharm 1994; 51: 1433-40
74. Wasylak TJ, Abhott FV, English MJM, et al. Reduction of post-operative morbidity following patient-controlled morphine. Can J Anaesth 1990; 37: 726-31
75. Thomas DW, Owen H, Patient-controlled analgesia, the need for caution. A case report and review of adverse incidents. Anaesthesia 1988; 43: 770-2
76. Notcutt WG, Knowles P, Kaldas R. Overdose from patient- controlled analgesia pumps. Br J Anaesth 1992; 69: 95-7
77. Etches RC. Respiratory depression associated with patient- controlled analgesia, a review of eight cases. Can J Anaesth 1994; 41: 125-32
78. Fleming BM, Coombs DW. A survey of complications documented in a quality-control analysis of patient-controlled analgesia in the postoperative patient. J Pain Symptom Manage 1992; 7: 463-9
79. Notcutt WG, Morgan RJM. Introducing patient-controlled analgesia for postoperative pain control into a district general hospital. Anaesthesia 1990; 45: 401-6
80. Schug SA, Torrie JJ, Safely assessment of postoperative pain management by an acute pain service. Pain 1993; 55: 387-91
81. Jones JG, Sapsford DJ, Wheatley RG. Postoperative hypoxnemia: mechanisms and time course. Anaesthesia 1990; 45: 566-73
82. Wheatley RG, Shepherd D, Jackson IJ, et al. Hypoxaemia and pain relief after upper abdominal surgery: comparison of IM and patient-controlled analgesia. Br J Anaesth 1992; 69: 558-61
83. Madej TH, Wheatley RG, Jackson IJ, et al. Hypoxaemia and pain relief after lower abdominal surgery: comparison of extradural and patient-controlled analgesia. Br J Anaesth 1992; 69: 554-7
84. Owen H, Kluger MT, Ilsley AH, et al. The effect of fentanyl administered epidurally by patient-controlled analgesia, continuous infusion, or a combined technique of oxyhaemoglobin saturation after abdominal surgery. Anaesthesia 1993; 48: 20-5
85. Andersen R, Krohg K. Pain as a major cause of postoperative nausea. Can Anaesth Soc J 1976; 23: 366-9
86. Walder AD, Aitkenhead AR. Antiemetic efficacy of metoclopramide when included in a patient-controlled analgesia infusion. Anaesthesia 1994; 49: 804-6
87. Barrow PM, Hughes DC, Redfern N, et al. Influence of droperidol on nausea and vomiting during patient-controlled analgesia. Br J Anaesth 1994; 72: 460-1
88. Roberts CJ, Millar JM, Goal VJ. The antiemetic effectiveness of droperidol during morphine patient-controlled analgesia. Anaesthesia 1995; 50: 559-62
89. Kaufmann MA, Rosow C, Schneiper P, et al. Prophylactic antiemetic therapy with patient-controlled analgesia: a double blind comparison of droperidol. metoclopramide and tropisetron. Anesth Analg 1994; 78: 988-94
90. Alexander R, Lovell AT, Seingry D, et al. Comparison of ondansetron and droperidol in reducing postoperative nausea and vomiting associated with patient-controlled analgesia. Anaesthesia 1995; 50: 1086-8
91. Hawkins R, Price K. The effects of an education video on patients' request for postoperative pain relief. J Adv Nurs 1993; 10: 32-40
92. Timmons ME, Bower FL. The effect of structured preoperative teaching on patients' use of patient-controlled analgesia (PCA) and their management of pain. Orthop Nurs 1993; 12: 23-51
93. Perry F, Parker RK, White PF, et al. Role of psychological factors in postoperative pain control and recovery with patient-controlled analgesia. Clin J Pain 1994; 10: 57-63
94. Egbert AM, Parks LH, Short LM, et al. Randomized trial of postoperative patient-controlled analgesia vs intramuscular narcotics in frail elderly men. Arch Intern Med 1990; 150: 1897-903
95. Owen H, Ilsley A, McLean CF. An audit of problems associated with patient-controlled analgesia. Anaesth Intensive Care 1997; 25: 179
96. Farmer M, Harper NJN, Unexpected problems with patient-controlled analgesia [letter]. BMJ 1992; 304: 574
97. Chisakuta AM, Nurse-call button on a patient-controlled analgesia pump [lelter]? Anaesthesia 1993; 47: 9
98. Wakerlin G, Larson CP. Spouse-controlled analgesia [letter]. Anesth Analg 1990; 70: 119
99. Lam FY. Patient-controlled analgesia by proxy [letter]. Br J Anaesth 1993; 70: 113
100. Rudolph H. An adaptive system for patient-controlled analgesia [PhD thesis]. Melbourne: University of Melbourne, 1996
101. Owen H, Plummer JL, Ilsley AH, et al. Variable-dose patient-controlled analgesia: a preliminary report. Anaesthesia 1995; 50: 855-7
102. Love DR, Owen H, Ilsley AH, et al. A comparison of variable-dose patient-controlled analgesia with fixed-dose patient-controlled analgesia. Anesth Analg 1996; 83: 1060-4
103. Owen H, Glavin RJ, Shaw NA. Ibuprofen in the management of postoperative pain. Br J Anaesth 1986; 58: 1371-5
104. Blackburn A, Stevens JD, Wheatley RG, et al. Balanced analgesia with intravenous ketorolac and patient-controlled morphine following lower abdominal surgery. J Clin Anesth 1995; 7: 103-8
105. Parker RK, Holtmann B, Smith I, et al. Use of ketorolac after lower abdominal surgery: effect on analgesic requirement and surgical outcome. Anesthesiology 1994; 80: 6-12
106. Plummer JL, Owen H, Ilsley AH, et al. Sustained-release ibuprofen as an adjunct 10 morphine patient-controlled analgesia. Anesth Ahalg 1996; 83: 92-6
107. Kehlet H. Postoperative pain relief - what is the issue? Br J Anaesth 1994; 72: 375-7