Department of Anesthesiology, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Mackay Medical College, Taipei, Taiwan.
Department of Anesthesiology, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Mackay Medical College, Taipei, Taiwan.
J Formos Med Assoc. 2019 Jan;118(1 Pt 2):299-304. doi: 10.1016/j.jfma.2018.05.008. Epub 2018 May 24.
Studies have suggested that intravenous patient-controlled analgesia (IV-PCA) can be used safely for the treatment of background pain in burn patients. However, no comprehensive protocols have been published. How patient or surgical factors correlate with the amount of opioid consumption remains unclear. The aim of this study is to provide an IV-PCA protocol for alleviating pain for burn injuries, and to assess factors correlated with opioid consumption.
At the Mackay Memorial Hospital, a retrospective analysis from June 27th to October 31st of 2015 was carried out to investigate the use of IV-PCA in relation to the demographic and clinical data of patients who suffered from burn injuries due to a massive explosion of flammable powder. A standardized morphine IV-PCA protocol with rapid escalation was implemented. Variables assessed included age, weight, gender, days of usage, total surface area burned (TBSAB) and operations.
Among the 23 patients who received IV-PCA for burn pain control, it was noted that the larger the TBSAB and the higher the visual analogue scale (VAS), the more amount of morphine was consumed. Correlations between morphine consumption positively with weight (P < 0.01), female gender (P < 0.01), severity of injury (P = 0.01), and negatively with receiving operations (P = 0.01) were statistically significant.
As the daily morphine consumption was positively correlated with TBSAB, VAS, weight, female gender, the use of our IV-PCA protocol was sufficient in the management of background pain for patients with major burn injury.
研究表明，静脉患者自控镇痛（IV-PCA）可安全用于治疗烧伤患者的背景疼痛。然而，目前尚未发表全面的方案。患者或手术因素与阿片类药物消耗之间的相关性尚不清楚。本研究旨在为烧伤疼痛提供 IV-PCA 方案，并评估与阿片类药物消耗相关的因素。
在马偕纪念医院，对 2015 年 6 月 27 日至 10 月 31 日期间因易燃粉末大规模爆炸而遭受烧伤的患者，回顾性分析了 IV-PCA 使用与患者人口统计学和临床数据的关系。采用快速递增的标准化吗啡 IV-PCA 方案。评估的变量包括年龄、体重、性别、使用天数、总烧伤表面积（TBSAB）和手术。
在 23 名接受 IV-PCA 治疗烧伤疼痛的患者中，发现 TBSAB 越大，视觉模拟评分（VAS）越高，吗啡消耗量越大。吗啡消耗与体重（P<0.01）、女性性别（P<0.01）、损伤严重程度（P=0.01）呈正相关，与手术（P=0.01）呈负相关。
由于每日吗啡消耗量与 TBSAB、VAS、体重、女性性别呈正相关，因此我们的 IV-PCA 方案足以管理大面积烧伤患者的背景疼痛。
