Ma C S, Lin D
The Queen's Medical Center, Honolulu, Hawaii.
Hosp Formul. 1991 Mar;26(3):198-201, 205-6.
Patient controlled analgesia (PCA) has a number of advantages compared with traditional methods of pain management. Some of these advantages include superior pain relief, less sedation due to superior drug titration, increased psychological satisfaction due to patient control of pain management, individualized analgesic dosing, decreased staff time for patient care, and increased patient activity and mobility. Although a few cases of respiratory depression have been reported with the use of PCA, there is a relatively low risk of this complication in most patient populations. Appropriate candidates for PCA include terminally ill-cancer patients, postoperative patients, mentally clear and alert trauma patients, and patients who require massive doses of oral narcotics to control pain but are experiencing intolerable side effects. This article focuses on the principles involved in selecting the optimal analgesic and the therapeutic variables involved in using PCA.
与传统的疼痛管理方法相比，患者自控镇痛（PCA）具有许多优势。其中一些优势包括更好的疼痛缓解效果、由于更优的药物滴定而减少镇静作用、患者对疼痛管理的控制增加心理满意度、个性化镇痛给药、减少医护人员护理患者的时间以及增加患者的活动和移动性。尽管使用PCA报告了少数几例呼吸抑制病例，但在大多数患者群体中这种并发症的风险相对较低。PCA的合适人选包括晚期癌症患者、术后患者、神志清醒且警觉的创伤患者，以及需要大剂量口服麻醉药来控制疼痛但出现无法耐受副作用的患者。本文重点关注选择最佳镇痛药所涉及的原则以及使用PCA所涉及的治疗变量。
