The results demonstrate that the patients' satisfaction with PCINA is comparable to that with i.v.-PCA. Both PCINA and i.v.-PCA were assessed as superior to the customarily prescribed pain management (P = 0.0001). Patients' acceptance of a given form of pain management is mainly related to its efficiency. However, side effects such as pain on injection with i.v.-PCA, or frequent opioid administration with PCINA, must be considered when assessing a method of pain control. Patients' global assessment includes both efficiency and side effects. PCINA represents an interesting alternative non-invasive method for postoperative pain management.
Recently, a new device for patient-controlled intranasal analgesia (PCINA) was described, and a pilot study demonstrated promising results with respect to efficacy and patient satisfaction. The present study compares PCINA with intravenous (IV) patient-controlled analgesia (PCA). Fifty orthopedic patients were prospectively studied over an 8-h period on the first day after surgery. The patients were randomly allocated to PCINA group (n = 25) or to an IV PCA group (n = 25). Pain intensity was evaluated at 30-min intervals using a 101-point numerical rating scale. With respect to initial pain intensity, there was no significant intergroup difference. At the 30- to 480-min measurement points pain intensity in the PCINA group (P < 0.0001) and the IV PCA group (P < 0.0001) was significantly less as compared to the initial value. There was no significant intergroup difference in pain intensity. No patient had problems using the PCINA device. The present study demonstrates, that PCINA provides relief of postoperative pain as effectively as IV PCA.
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