RESUMEN
Recent reports have suggested that patient-controlled analgesia is an effective means of narcotic administration in postoperative patients. This prospective investigation was undertaken to determine the efficacy and safety of patient-controlled anesthesia infusion after cesarean section. During a recent ten-month period, 130 patients were assigned randomly to receive meperidine by pump or intramuscular injection. Meperidine consumption using the device varied widely to meet individual needs. Overdosage and drug dependence were not encountered with the prescribed drug concentrations. The patient-controlled analgesia method provided less sedation and more immediate pain relief without the need for painful injections. The additional cost of renting the infuser device was offset by combined patient and nursing satisfaction. We conclude that patient-controlled infusion of meperidine is safe and effective in satisfying individual patient needs after cesarean section.
Asunto(s)
Analgesia/métodos , Cesárea , Dolor Postoperatorio/terapia , Estudios de Evaluación como Asunto , Femenino , Humanos , Bombas de Infusión , Inyecciones Intramusculares/enfermería , Meperidina/administración & dosificación , Dimensión del Dolor , Embarazo , Estudios Prospectivos , Distribución Aleatoria , Autoadministración/instrumentación , Autoadministración/métodosRESUMEN
New patient-controlled analgesia devices can deliver an analgesic by continuous infusion along with demand dosing. This prospective investigation involving postcesarean-section patients was undertaken to determine whether a combination of continuous infusion and demand dosing of meperidine would provide more effective analgesia than would demand dosing alone during the first 24 hours. During a 12-month period, 171 patients were prescribed meperidine postoperatively, using a 5- to 10-mg demand dose no more frequently than every 10 minutes. Patients were assigned to groups receiving no continuous infusion or infusion at rates of 10, 20, or 30 mg/h. The groups receiving continuous infusion showed more immediate and sustained pain relief, with no serious complications. All patients were able to understand the nurse, became ambulatory, and tolerated liquids on the first postoperative day. The infusion rate of 20 mg/h was most acceptable in requiring fewer demand doses while providing satisfactory pain relief without undesired sedation. In conclusion, a system combining continuous infusion and demand dosing was preferable to demand dosing alone, and added no apparent hazards.