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Evidence summaries

Patient-Controlled Analgesia for Postoperative Pain

Patient-controlled opioid treatment gives similar analgesia for postoperative pain as conventional opioid treatment but reduces the number of pulmonary complications and increases patient satisfaction. Level of evidence: "A"

A systematic review 1 including 32 RCTs with a total of 2 111 subjects was abstracted in DARE. The cumulative opioid consumption during the first 20- to 24-hour post-operative period was similar in patient-controlled analgesia (PCA) and control groups. Also the average pain intensity at 24 hours and the duration of hospital stay were similar in PCA and control groups.

In studies reporting patient satisfaction the data were slightly in favour of PCA. There were less pulmonary complications in PCA group.

Bradypnoea, hypoxia, nausea and/or vomiting, sedation, pruritus, and urinary retention occurred with both the PCA and control treatments. There was no evidence of any difference between the two analgesic techniques.

    References

    • Walder B, Schafer M, Henzi I, Tramèr MR. Efficacy and safety of patient-controlled opioid analgesia for acute postoperative pain. A quantitative systematic review. Acta Anaesthesiol Scand 2001 Aug;45(7):795-804. [PubMed] [DARE]

Primary/Secondary Keywords