Albert J M, Talbott T M
Ferguson Clinic, Grand Rapids, Michigan 49503.
Dis Colon Rectum. 1988 Feb;31(2):83-6. doi: 10.1007/BF02562633.
Though patient-controlled analgesia (PCA) has been in use for over a decade, it has been popularized only recently. Conventional techniques of intermittent intramuscular (IM) administration of analgesia have fallen short of meeting the needs of patients following major abdominal surgery. This has prompted a search for methods to improve postoperative pain management. Though PCA has been accepted in many hospitals, few studies comparing conventional IM administration of morphine with PCA have been performed. A prospective randomized study comparing IM- and PCA-administered morphine in 62 patients undergoing colon surgery was performed. A comparison of the efficacy of analgesia and extent of sedation using these approaches shows that PCA allows for analgesia with less sedation and less drug requirement than that of IM administration. No differences were noted in postoperative duration of ileus, duration of hospitalization, and total hospital costs. This study confirms the safety and efficacy of PCA, and should be considered the current optimal method of controlling pain following major colonic surgery.
尽管患者自控镇痛（PCA）已应用了十多年，但直到最近才得以普及。传统的间歇性肌内注射（IM）镇痛技术已无法满足腹部大手术后患者的需求。这促使人们寻找改善术后疼痛管理的方法。尽管PCA已在许多医院被采用，但很少有研究对传统的肌内注射吗啡与PCA进行比较。我们进行了一项前瞻性随机研究，比较了62例接受结肠手术患者中肌内注射和PCA注射吗啡的情况。对使用这些方法的镇痛效果和镇静程度进行比较后发现，与肌内注射相比，PCA能在镇静作用较小且药物需求量较少的情况下实现镇痛。在术后肠梗阻持续时间、住院时间和总住院费用方面未发现差异。这项研究证实了PCA的安全性和有效性，应被视为目前结肠大手术后控制疼痛的最佳方法。
