Postoperative patient controlled analgesia using a low-tech PCA system

• Published in: Acute pain : international journal of acute pain management 1999-03, Vol.2 (1), p.17-26
• Main Authors: Likar, Rudolf, Jost, Robert, Mathiaschitz, Klaus, Krumpholz, Ruth, Pipam, Wolgang, Kapral, Stephan, Sittl, Reinhard
• Format: Article
• Language: English
• Subjects: patient controlled analgesia; piritramid; side effects; tramadol/dipyrone
• ISSN: 1366-0071; 1873-6319
• DOI: 10.1016/S1366-0071(99)80030-8

The aim of this randomised, double-blind study was to determine whether a low-tech patient controlled analgesia (PCA) model with various dose aliquots of piritramid or a combination of tramadol/dipyrone is suitable for use in postoperative pain therapy. By suitable the authors mean (a) whether effective analgesia can be attained; (b) whether patients can understand and appropriately use the PCA pump; and (c) whether good patient acceptance is achieved. The authors studied 82 patients (ASA I–II) aged between 18–70 years. The patients were divided into four subgroups. All patients received a start-up loading dose of the same analgesic which they thereafter received via the PCA pump. The aliquots of drug provided by the PCA pump were always contained in 0.5 ml. This volume, however, contained different amounts of analgesic: piritramid either (1) 1.5 mg (high dose) or (2) 0.75 mg (low dose); (3) tramadol 10 mg with dipyrone 50 mg (high dose mixture); (4) tramadol 5 mg with dipyrone 25 mg (low dose mixture). The results showed that the PCA device is suitable for use in postoperative pain therapy. The rate of side effects was low. In the first 24 hours, the consumption of analgesics was similar in the low dose aliquot and high dose aliquot groups: Group (1) 43.5 mg piritramid; Group (2) 37.2 mg piritramid; Group (3) 267 mg/1335 mg tramadol/dipyrone; Group (4) 256 mg/1275 mg tramadol/dipyrone. Analgesia was effective, as judged by visual analogue scale (VAS) scores of 4 or less. Up to the 12th hour the VAS score was noted to be lower (more effective analgesia) in the tramadol/dipyrone group as compared to the piritramid group. In conclusion, a postoperative PCA regimen using a low-tech PCA device provides effective analgesia with a low rate of side effects and is suitable for use in postoperative patients.