PURPOSE: The goal of postoperative pain management is to provide safe, continuous, effective analgesia, free from unwanted side effects. In doing so, it is hoped that postoperative morbidity is reduced, facilitating recovery, and hasten discharge from hospital. However, the effects of patient-controlled analgesia (PCA) and complications after a major gastrointestinal operation are currently unclear.
METHODS: Fifty four and 31 patients who had undergone an elective gastrectomy due to stomach cancer and elective colorectal surgery due to colorectal cancer, respectively, between August 2002 and April 2003 at the Hanyang University Hospital, were allocated to one of two groups; One received patient-controlled analgesia (PCA group), the other received preoperative fentanyl patch appliment (Patch group). The kind and amount of additional analgesics demanded, pain scale, clinical course, and side effects were analyzed.
Result: After the stomach cancer surgery, the average postoperative pain scores (numeric scale+pain face scale) in the PCA and patch groups were 9.44 and 10.76, respectively (P=0.0325). After the colorectal cancer surgery, the average postoperative pain scores in the PCA and patch groups were 6.44 and 9.22, respectively (P=0.0072). The amount of additional analgesic agent required after gastrointestinal surgery was variable and unpredictable, but IV PCA resolved this problems and markedly reduced the need for additional analgesic agents. The clinical courses of the PCA and patch groups did not differ in terms of gas passing and resumption of diet. The complication rates of the two groups were similar.
CONCLUSION: IV PCA after gastrointestinal surgery for stomach and colon cancers is better for the management of postoperative pain than other pain control methods, with similar complication rates.
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