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Article: The efficacy, applicability and side-effects of postoperative intravenous patient-controlled morphine analgesia: An audit of 1233 Chinese patients

TitleThe efficacy, applicability and side-effects of postoperative intravenous patient-controlled morphine analgesia: An audit of 1233 Chinese patients
Authors
KeywordsAnalgesia
Pain: postoperative
Techniques: patient controlled, PCA
Issue Date1996
PublisherAustralian Society of Anaesthetists. The Journal's web site is located at http://www.aaic.net.au
Citation
Anaesthesia And Intensive Care, 1996, v. 24 n. 6, p. 658-664 How to Cite?
AbstractWe analyzed data from 1233 Chinese patients of a wide age range who received patient-controlled analgesia (PCA) intravenous morphine for postoperative pain relief during the period from January 1992 to May 1995. The analgesic regimen was standardized as follows: PCA bolus 1 to 1.5 mg; lock-out interval 5 minutes; one-hour maximum dose 0.075 to 0.1 mg.kg-1 and background infusion 0 or 0.5 mg.h-1. Most patients underwent major surgery that was broadly subclassified according to the anatomical area involved. The median verbal numerical rating scales of pain (0 to 10) at rest and while coughing for the first, second and third 24 hours were 3.0/5.0, 1.5/4, 0 and 0/3, 0 respectively and the corresponding demand to delivery ratios were 2.8 ± 2.9, 2.6 ± 2.4 and 2.4 ± 2.6. The overall morphine consumptions in 1004 of these Chinese patients were 27.5 ± 16.8, 178 ± 16,1 and 18.1 ± 21.0 μg.kg-1.h-1 during the first 16, 17 to 41 and 42 to 66 postoperative hours respectively. These figures were the same as for Caucasian patients managed in the same institution. Morphine consumption was significantly higher following thoracic, upper abdominal and spinal surgery. Also it was higher in patients younger than 65 years, males, cigarette smokers and those with ASA physical status I or II. The commonest side-effects were nausea (34.5%) and vomiting (18.2%). Bradypnoea and oxygen desaturation occurred in 0.5% and 1.6% respectively. All cases were promptly detected and managed with no adverse outcomes. Most patients were satisfied (76.7% ranked 'good') with their postoperative analgesia. The commonest reasons for dissatisfaction were inadequate pain relief, nausea and reluctance to selfcontrol analgesic administration. It is concluded that PCA with intravenous morphine is effective and safe as a routine postoperative technique for Chinese surgical patients.
Persistent Identifierhttp://hdl.handle.net/10722/67277
ISSN
2015 Impact Factor: 1.283
2015 SCImago Journal Rankings: 0.488
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTsui, SLen_HK
dc.contributor.authorTong, WNen_HK
dc.contributor.authorIrwin, Men_HK
dc.contributor.authorNg, KFJen_HK
dc.contributor.authorLo, JRen_HK
dc.contributor.authorChan, WSen_HK
dc.contributor.authorYang, Jen_HK
dc.date.accessioned2010-09-06T05:53:33Z-
dc.date.available2010-09-06T05:53:33Z-
dc.date.issued1996en_HK
dc.identifier.citationAnaesthesia And Intensive Care, 1996, v. 24 n. 6, p. 658-664en_HK
dc.identifier.issn0310-057Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/67277-
dc.description.abstractWe analyzed data from 1233 Chinese patients of a wide age range who received patient-controlled analgesia (PCA) intravenous morphine for postoperative pain relief during the period from January 1992 to May 1995. The analgesic regimen was standardized as follows: PCA bolus 1 to 1.5 mg; lock-out interval 5 minutes; one-hour maximum dose 0.075 to 0.1 mg.kg-1 and background infusion 0 or 0.5 mg.h-1. Most patients underwent major surgery that was broadly subclassified according to the anatomical area involved. The median verbal numerical rating scales of pain (0 to 10) at rest and while coughing for the first, second and third 24 hours were 3.0/5.0, 1.5/4, 0 and 0/3, 0 respectively and the corresponding demand to delivery ratios were 2.8 ± 2.9, 2.6 ± 2.4 and 2.4 ± 2.6. The overall morphine consumptions in 1004 of these Chinese patients were 27.5 ± 16.8, 178 ± 16,1 and 18.1 ± 21.0 μg.kg-1.h-1 during the first 16, 17 to 41 and 42 to 66 postoperative hours respectively. These figures were the same as for Caucasian patients managed in the same institution. Morphine consumption was significantly higher following thoracic, upper abdominal and spinal surgery. Also it was higher in patients younger than 65 years, males, cigarette smokers and those with ASA physical status I or II. The commonest side-effects were nausea (34.5%) and vomiting (18.2%). Bradypnoea and oxygen desaturation occurred in 0.5% and 1.6% respectively. All cases were promptly detected and managed with no adverse outcomes. Most patients were satisfied (76.7% ranked 'good') with their postoperative analgesia. The commonest reasons for dissatisfaction were inadequate pain relief, nausea and reluctance to selfcontrol analgesic administration. It is concluded that PCA with intravenous morphine is effective and safe as a routine postoperative technique for Chinese surgical patients.en_HK
dc.languageengen_HK
dc.publisherAustralian Society of Anaesthetists. The Journal's web site is located at http://www.aaic.net.auen_HK
dc.relation.ispartofAnaesthesia and Intensive Careen_HK
dc.subjectAnalgesiaen_HK
dc.subjectPain: postoperativeen_HK
dc.subjectTechniques: patient controlled, PCAen_HK
dc.subject.meshAnalgesia, Patient-Controlled - adverse effects-
dc.subject.meshAnalgesics, Opioid - administration and dosage - adverse effects-
dc.subject.meshInfusions, Intravenous-
dc.subject.meshMorphine - administration and dosage - adverse effects-
dc.subject.meshPain, Postoperative - drug therapy-
dc.titleThe efficacy, applicability and side-effects of postoperative intravenous patient-controlled morphine analgesia: An audit of 1233 Chinese patientsen_HK
dc.typeArticleen_HK
dc.identifier.emailIrwin, M:mgirwin@hku.hken_HK
dc.identifier.emailNg, KFJ:jkfng@hkucc.hku.hken_HK
dc.identifier.authorityIrwin, M=rp00390en_HK
dc.identifier.authorityNg, KFJ=rp00544en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid8971312-
dc.identifier.scopuseid_2-s2.0-0030465812en_HK
dc.identifier.hkuros22745en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0030465812&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume24en_HK
dc.identifier.issue6en_HK
dc.identifier.spage658en_HK
dc.identifier.epage664en_HK
dc.identifier.isiWOS:A1996VY40300004-
dc.publisher.placeAustraliaen_HK

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