The effectiveness of patient-controlled interscalene analgesia (PCISA) and patient-controlled intravenous analgesia (PCIVA) in the management of postoperative pain in 36 patients was studied. The general anesthetic technique was standardized. After surgery, all patients received 2 mg intravenous morphine. The patients were then randomized to receive either PCISA or PCIVA. The PCISA group received an interscalene block with 20 ml of 1% lidocaine. A catheter was introduced within the interscalene sheath and 20 min after the initial block, patients received a continuous infusion of 0.125 bupivacaine at rate of 4 ml/h supplemented by a bolus dose of 3 ml with a 15-min lockout time. PCIVA was given as a 1 mg morphine bolus and a 7-min lockout time. Pain relief was regularly assessed using a visual analog scale. Side effects and patient satisfaction were noted. The study period ended 48 h after the operation. Pain relief was significantly better controlled in the PCISA group 6, 12, 24, and 30 h after the operation (P<0.05). At 36, 42, and 48 h, no significant difference in pain score between the two groups was observed. Patient satisfaction was greater in the PCISA group (P<0.05). Vomiting and pruritus were observed more frequently in the PCIVA group (P<0.05). No major complications occurred in any of the study patients. The use of the PCISA technique was uncomplicated and provided better pain relief than PCIVA in postoperative analgesia.
European Journal of Plastic Surgery – Springer Journals
Published: Apr 27, 2002
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