Patient-controlled analgesia compared with nurse-controlled infusion analgesia after heart surgery

O’Halloran, Peter; Brown, Robert H.

doi:10.1016/s0964-3397(97)80825-7

Cited by 29 publications

(32 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…only provided the overall mean pain score (possible score 0–10) of the first 24 h where there was no significant difference ( P > 0.05) between the PCA group ( n = 91, mean = 2.1, SD = 1.5) and the NCA group ( n = 78, mean = 1.7, SD = 1.5). This is consistent with the other study by O'Halloran and Brown, 30 which also demonstrated lower scores in the PCA group than the NCA group both at rest and with movement (Table 1). Lack of data in the other study 30 prevented the results from being combined in a meta‐analysis.…”

Section: Resultssupporting

confidence: 93%

“…The two studies 30,42 found that there was no significant difference between the PCA and NCA groups in the level of pain reported with groups in each study reporting that each group had similar pain scores. Murphy et al 42 .…”

Section: Resultsmentioning

confidence: 99%

“…Two studies tested the efficacy of IV analgesia via a PCA device versus nurse controlled infusion (NCA, nurse controlled analgesia) 30,42 . One of the studies 30 ( n = 66) involved patients undergoing elective cardiac surgery while the second study 42 ( n = 200) involved patients who underwent a scheduled, elective laparotomy or thoracotomy. Analgesia used in the studies included morphine 30 and pethidine 42 …”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Systematic review of the effectiveness of nursing interventions in reducing or relieving post-operative pain

Crowe

Chang

Fraser

et al. 2008

International Journal of Evidence-Based Healthcare

View full text Add to dashboard Cite

Objectives The primary objective of this systematic review was to assess the effectiveness of nursing interventions for the relief/reduction of post-operative pain when compared with either standard care or other nursing interventions. Inclusion criteria Types of studies This review included randomised controlled trials (RCTs) and other quasi-randomised experimental research designs. Types of participants Adults treated for post-operative pain in an acute care hospital. Types of interventions Interventions included in the review were only those directly administered by nursing staff such as: (i) administration of analgesia: including oral, intramuscular injection, patient controlled analgesia, epidural; (ii) pre-operative patient education; (iii) assessment and documentation of intensity of pain at regular intervals; (iv) protocols, clinical pathways or flow-sheets used in the management of pain; and (v) non-pharmacological interventions such as massage and relaxation. Types of outcome measures The primary outcome was the relief or reduction of post-operative pain. Other measures included analgesia consumption, patient satisfaction and length of hospital stay. Search strategy Search terms were chosen after reviewing text words and MeSH terms in relevant articles and databases. A search for published and unpublished research covering the period 1985-2004 (inclusive) was conducted, using 11 major electronic databases. Reference lists of retrieved articles were hand searched. The search was restricted to reports published in English. Assessment of quality The methodological quality of eligible studies was appraised by two independent reviewers, using a standardised critical appraisal tool. Differences in opinion were decided by consensus after discussion with a third investigator. Data extraction and analysis Data were extracted from the studies that met the criteria for methodological quality. Two reviewers independently extracted data for each study, using a standardised extraction tool. Results from homogeneous RCTs where possible were pooled in meta-analysis using RevMan4.2 software program. If the studies were clinically or statistically heterogeneous, the results are discussed in a narrative form. Non-randomised studies are also discussed in narrative form. Results Overall, there is no strong evidence to support the use of any intervention even though a few interventions showed some benefits. However, evidence for these benefits was often based on single studies. Most of the included studies showed that there was no difference between the interventions and the usual care with both being found equally effective. Implications for practice There was no strong evidence to support a particular practice. No intervention was found to be harmful; however, this does not presume to be evidence of safety. When there are two similarly effective interventions nurses need to weigh the possible positive and negative of the intervention including side effects, risk of adverse events, cost and patient preference. Other ...

show abstract

Section: Resultssupporting

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Systematic review of the effectiveness of nursing interventions in reducing or relieving post-operative pain

Crowe

Chang

Fraser

et al. 2008

International Journal of Evidence-Based Healthcare

View full text Add to dashboard Cite

show abstract

“…14 This left ten eligible trials, including nine papers [15][16][17][18][19][20][21][22][23] and one abstract 24 involving a total of 666 patients (Table I). The median Jadad score was 3 (range: 2-4).…”

Section: Resultsmentioning

confidence: 99%

Patient-controlledversus nurse-controlled analgesia after cardiac surgery — a meta-analysis

Bainbridge¹,

Martin

Cheng³

2006

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Background: Patient-controlled analgesia (PCA) has been advocated as superior to conventional nurse-controlled analgesia (NCA) with less risk to patients. This systematic review and meta-analysis sought to determine whether PCA improves clinical and resource outcomes when compared with NCA. Methods:A comprehensive search was undertaken to identify all randomized controlled trials of PCA vs NCA. Medline, Cochrane Library, Embase, and conference abstract databases were searched from the date of their inception to August 2005. The primary postoperative outcome was defined as mean visual analogue scale (VAS) scores. Secondary postoperative outcomes included cumulative morphine equivalents, intensive care unit (ICU) and hospital length of stay, postoperative nausea and vomiting, sedation, respiratory depression, and all-cause mortality. Odds ratios or weighted mean differences (WMD) and their 95% confidence intervals (CI) were calculated for discrete and continuous outcomes, respectively.Results: Ten randomized trials involving 666 patients were included. Compared to NCA, PCA significantly reduced VAS at 48 hr (WMD -0.73, 95% CI -1.19, -0.27), but not at 24 hr (WMD -0.19, 95% CI -0.61, 0.24). Cumulative morphine equivalents consumed were significantly increased at 24 hr (WMD 6.84 mg, 95% CI 0.97, 12.72 mg), and at 48 hr (WMD 10.46 mg 95% CI 2.02, 18.9 mg) for PCA compared with NCA. Ventilation times, length of ICU stay, length of hospital stay, patient satisfaction scores, sedation scores, and incidence of postoperative nausea and vomiting, respiratory depression, severe pain, discontinuations, and death were not significantly different between groups, but these outcomes were generally under-reported. Conclusions:In postcardiac surgical patients, PCA increases cumulative 24 and 48 hr morphine consumption, and improves 48-hr VAS compared with NCA. Objectif

show abstract

“…Patients in the phase 1 group, who discontinued the PCA system at 40 h, showed considerably higher VAS scores at POD 3-5 and frequently required additional analgesic drugs, including oral NSAIDs or intravenous pentazocine. Although previous investigations of intravenous PCA discontinued the PCA at POD 2-3 [12][13][14][15][16], we consider that employing PCA for only 2-3 days after cardiac surgery is not sufficient. Similarly, when thoracic epidural analgesia (TEA) was discontinued at POD 3, it did not shorten the length of hospital stay or rehabilitation procedure [17].…”

Section: Discussionmentioning

confidence: 78%

Five-day pain management regimen using patient-controlled analgesia facilitates early ambulation after cardiac surgery

et al. 2010

View full text Add to dashboard Cite

show abstract

Patient-controlled analgesia compared with nurse-controlled infusion analgesia after heart surgery

Cited by 29 publications

References 7 publications

Systematic review of the effectiveness of nursing interventions in reducing or relieving post-operative pain

Systematic review of the effectiveness of nursing interventions in reducing or relieving post-operative pain

Patient-controlledversus nurse-controlled analgesia after cardiac surgery — a meta-analysis

Five-day pain management regimen using patient-controlled analgesia facilitates early ambulation after cardiac surgery

Contact Info

Product

Resources

About