Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Fuchs, S.
Paediatric Intravenous Patient-Controlled Analgesia (PCA)
Analysis of safety and efficacy of intravenous PCA at the Dept. of Paediatric Anaesthesia, Medical University Graz, in 2009
[ Diplomarbeit ] Medical University of Graz; 2012. pp. 82
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Sandner-Kiesling Andreas
- Vittinghoff Maria
- Altmetrics:
- Abstract:
- Introduction: The Paediatric Anaesthesia Department of the Medical University Graz has more than 15 years' worth of experience with patient-controlled analgesia (PCA) in combination with a continuous infusion. The aim of this thesis is to analysis its safety and efficacy. Methods: The data of the first completely digitalised year 2009 were gathered retrospectively. It included all surgical, non-oncological patients in the range of 0-18 years who received intravenous PCA. Non-parametric tests were used to analyse two different fillings of PCA: tramadol/metamizole PCA and piritramide PCA. Results: In the age group 0-5 years old 75% of the patients stayed beneath the threshold of intervention (pain score 4). For the age groups of 6-13 and 14-18 years old, 43% and 27% of the patients, respectively, stayed below the pain intervention threshold, respectively. Patients treated with tramadol/metamizole PCA reported pain less frequently than those treated with piritramide PCA (53.3% versus 31.3% were below intervention threshold). Eight per cent of all patients experienced oxygen desaturation (SaO2 <94%). The longest use of tramadol / metamizole PCA which was 7 days in total showed an association with a more frequent occurrence of oxygen desaturation during these days. Nausea and/or emesis in the first 24h post-operative (PONV) were reported by 8% of the 0-5 years old, 55% of the 6-13 years old, 68% of the 14-18 years old females and 23% of the 14-18 years old males. After the first 24 post-operative hours 22.9% of all patients reported nausea and/or emesis. Eighty-nine per cent of the patients with nausea and/or emesis during the first 24 post-operative hours experienced it later on, too. In median, males stayed one day longer in the hospital. Conclusion: PCA with continuous infusion is a safe and effective form of post-operative pain treatment for patients between the age of 0-18 years. We observed a decrease in its efficacy between 14-18 years of age. Moreover patients with incidences of nausea and/or emesis during the first 24 post-operative hours and female patients in the age of 14-18 years should be considered as high risk patients for nausea & emesis. Further studies have to examine our results and shall answer the remaining open questions prospectively.