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KMID : 0377519980230030145
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Chung-Ang Journal of Medicine
1998 Volume.23 No. 3 p.145 ~ p.153
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The Effects Timming of Connention with Intravenous PCA
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Kim Sok-Ju
Oh Soo-Won
Park Sun-Gyoo
Koo Gill-Hoi
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Abstract
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Postoperative pain is now regarded as controllable thing, further one that must be controlled, not as inevitable one no longer. In according to increasing need of pain control, efforts that would maximize the analgesic effects and minimize the undesirable effects are in process. To obtain these, the development of new ideal drugs and more accurate clarification of pain mechanism, improvement of preexisting pain control systems will be needed. Furthermore, if there would not necessary additional manpower or instruments or delicate skill, it would be better. So authors conducted this study to examine the influence of timing of connection with intravenous PCA(pain controlled analgesia) equipment to pain control by consuming amount of rescue analgesics and change of vital signs during immediate postoperative periods. Objects are those who were going to have an elective operation expected during less than three hours and ASA class 1 or 2. Among those who applied to take PCA after their operation and were from twenties to sixties and who would be expected operation in upper abdomen or chest were excluded. Patients were divided into three groups, A, B and C. Group A started to control pain by taking PCA before the operation stimulation (skin incision) after anesthetizing, group B took it for taking an anesthetic when the operation was getting over, and group C took it right after when they were brought to the recovery room. We measured blood pressure and heart rate every five minutes during 30 minutes after when they were brought to the recovery room. Pain was scored to three degree from zero to three. When the score is more than 1, we gave them intravenous nalbuphine 5 mg. Ten minutes later, pain score was measured repeatedly and if the score is more than 1, we gave them nalbuphine 5 mg again, and repeated it ten minutes later. We recorded the amount of nalbuphine during the time they were in the recovery room, and the side effects during that time. We also asked about whether they felt pain or not when they got out of the recovery room and recorded as yes or no. There were no statstically significant differences in three groups on the change of blood pressure and heart rate, and the time that takes for regain of their consciousness at the recovery room. but there were statstically significant differences in the amount of nalbuphine as rescue medicine and whether they felt pain or not when they got out of the recovery room between group A and C. In group A, less rescue medicine were consumed and less patients felt painful when they got out of the recovery room in compaing to group A. Requirement of analgesics could be reduced in immediate postoperative period by initiating and continuing pain control before operation stimulation was beginning and it was possible without extra bolus dose.
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KEYWORD
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preemptive analgesia, nalbuphine, ketolorac, postoperative pain
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