Use of breath-activated Patient Controlled Analgesia for acute pain management in a patient with quadriplegia

Jastrzab, Grazyna; Khor, Kok Eng

doi:10.1038/sj.sc.3100790

Cited by 5 publications

(3 citation statements)

References 7 publications

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“…47 This concept has previously been reported also for successful PCA in a quadriplegic patient. 48 Elastomeric devices were more or less continuously introduced since PCA received worldwide attention. Cost considerations were not always in favor of disposable mechanically (in comparison with electronically) controlled pumps, but the simple systems seem to have found their place, particularly in ambulatory care using local anesthetics.…”

Section: New Devices and Application Strategiesmentioning

confidence: 99%

Recent Developments in Patient-Controlled Analgesia

Lehmann

2005

Journal of Pain and Symptom Management

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Patient-controlled analgesia (PCA) has become the gold standard for acute pain management since it was first introduced 20 years ago, and its merits have been discussed in quite a large number of publications. This review summarizes the more recent developments, such as new application devices and strategies, including intranasal, spinal, and regional PCA; patient-controlled sedation; experience with children and elderly people; and some data from chronic pain situations. Analyzing PCA literature from 2001 onwards confirms the author's long belief that the PCA principle ("WYNIWYG": what you need is what you get) was the most important aspect of a patient-controlled strategy, more or less independent of the type of drug or machine. Discovering this principle has changed the understanding of pain and suffering.

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Section: New Devices and Application Strategiesmentioning

confidence: 99%

Recent Developments in Patient-Controlled Analgesia

Lehmann

2005

Journal of Pain and Symptom Management

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“…Specifically, the inability to reliably push a demand button creates a need for innovative approaches to patient‐controlled drug delivery. Hands‐free PCA demand buttons have been described previously, including a foot pedal system and a breath‐activated system, in which the patient breathes into a tube attached to the PCA machine triggering the release of intravenous opioid medication . Although our patient did not require a PCA system, it is important for anesthesiologists to be familiar with options available for patients with compromised hand function.…”

Section: Discussionmentioning

confidence: 99%

Pain Management in Four‐Limb Amputation: A Case Report

Warner

Moeschler

et al. 2015

Pain Practice

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Acute pain following amputation can be challenging to treat due to multiple underlying mechanisms and variable clinical responses to treatment. Furthermore, poorly controlled preoperative pain is a risk factor for developing chronic pain. Evidence suggests that epidural analgesia and peripheral nerve blockade may decrease the severity of residual limb pain and the prevalence of phantom pain after lower extremity amputation. We present the perioperative analgesic management of a patient with gangrene of the bilateral upper and lower extremities as a result of septic shock and prolonged vasopressor administration who underwent four-limb amputation in a single procedure. A multimodal analgesic regimen was utilized, including titration of preoperative opioid and neuropathic pain agents, perioperative intravenous, epidural and peripheral nerve catheter infusions, and postoperative oral medication titration. More than 8 months postoperatively, the patient has satisfactory pain control with no evidence for phantom limb pain. To our knowledge, there have been no publications to date concerning analgesic regimens in four-limb amputation.

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“…A breath‐activated PCA device has also been described for a quadriplegic patient in Australia. It consisted of a flexible tube with a soft vinyl mouthpiece, which was supplied by the PCA pump manufacturer (Abbott, Australasia) [4].…”

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confidence: 99%