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KMID : 0356919950280060842
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Korean Journal of Anesthesiology
1995 Volume.28 No. 6 p.842 ~ p.848
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A Comparison of the Effect of Intravenous Patient-Controlled Analgesia vs Intramuscular P.R.N Opioid Regimen on Heart Rate, Blood Pressure, Rate Pressure Product, and Visual Analogue Scale following Abdominal Hysterectomy
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Abstract
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Previous studies have shown that patient-controlled analgesia(PCA) provides effective pain control in the postoperative patient. To compare the effect of pain relief on postoperative sympathetic responses and myocardial oxygen consumption, 40
healthy
female patients undergoing abdominal hysterectomy were chosen randomly, They underwent pain management with either intravenous patient-controlled analgesia(IV PCA) or intermittent intramuscular opioid(IM P.R.N) regimen. Pain intensity(VAS), heart
rate,
blood pressure, and rate pressure product(RPP) were measured at predetermine time intervals for postoperative 72 hours after measurement of preoperative baseline values. Comparisons were then made between the two groups and among individuals
within
each
group.
IV-PCA improved postoperative pain relief(P<0.05), but did not suppress efficiently the heart rate, blood pressure, and RPP indicating sympathetic responses and myocardial oxygen consumption when compared with IM P.R.N regimen. These variables
were
increased immediately and/or 30 minutes following the operation in both groups when compared with preoperative baseline value (P<0.05).
These results suggest that improved pain relief per se by IV PCA had no major influence on the suppression of sympathetic responses and myocardial oxygen consumption and these responses were exaggerated during first 30 minutes after abdominal
hysterectomy.
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KEYWORD
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