Assessment of Post-Operative Pain Control Using Convential Parenteral Route versus Patient Controlled Analgesia

Date

2016-1

Type

Article

Journal title

Issue

Vol. 1 No. 4

Author(s)

Nasruddin E. EL-Reyani

Pages

61 - 68

Abstract

Abstract Pain management following surgical interventions is a crucial for patient satisfaction and rapid recovery. Therefore, models to improve patient pain outcomes will achieve these goals. Patient controlled analgesia (PCA) is an alternative method used to control different types of pain compared to other routes. The present study was aimed to assess postoperative pain intensity in patients after surgical interventions using either parenteral pain killers or an intravenous PCA. In this study, one hundred and sixty eight patients who underwent different surgical operations were divided into six groups with a subsequent PCA group. After pain intensity was evaluated, each patient received either pethidine, diclofenac sodium or paracetamol (drug analgesic therapy) one hour after recovery from anesthesia. Time from the initiation of treatment to the request for analgesics was measured and represents the effectiveness of the analgesic drug or PCA treatments. In addition, the total medications intake was recorded during the first 12 postoperative hours. Our findings showed that postoperative pain scores at 1 hour and 12 hours after surgery were significantly (p <0.05) lower among all the patients compared with pre-analgesic treatments. Furthermore, in the PCA patients group, the pain scores were lower in major surgery with more patients satisfaction compared with other treated groups (p<0.05). Overall, painkiller administration was higher in the six groups but this difference was found to be not statistically significant compared with intravenous PCA group. Thus, it is concluded that intravenous PCA model is an effective approach that can manage acute postoperative pain and improve patient satisfaction. Keywords: Postoperative pain; Pain score; Analgesia; Patient; Analgesic Objectives: To estimate the prevalence of non-dipping BP status in a sample of Libyan hypertensive patients. Also, to give a hint on the possible drug therapy used worldwide to control the non-dipping phenomenon. Methods: A sample of 64 hypertensive patients aged 17 to 79 years old were recruited randomly. A 24 hrs. ambulatory BP monitoring (ABPM) was used to estimate and evaluate the blood pressure pattern in the sample selected. The study was performed at two private clinics in Tripoli city, Libya to explore the incidence and prevalence of non-dipping patterns among selected population. Dipping was calculated from the average day and average night systolic blood pressure measures. Results: 54.7% of the included patients were non-dippers. There was a significant association of the non-dipping with increasing age. No significant association with the other studied variables. Conclusion: This study showed that a non-dipping BP pattern is common among Libyan patients and in particular older hypertensive patients. This observation suggests the possibility of high-risk cardiovascular morbidity and mortality. The study also showed that there is a need for increased utilization of the ABPM before commencing drug therapy in Libyan hypertensive patients particularly non-controlled ones. Keywords: Hypertension, ABPM, dippers, non-dippers.

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