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- L Gagliese, M Jackson, P Ritvo, A Wowk, and J Katz.
- Acute Pain Research Unit, Department of Anaesthesia, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada. lucia.gagliese@uhn.on.ca
- Anesthesiology. 2000 Sep 1;93(3):601-10.
BackgroundObstacles to the use of patient-controlled analgesia (PCA) by elderly surgical patients have not been well-documented. Age differences in preoperative psychological factors, postoperative pain and analgesic consumption, treatment satisfaction, and concerns regarding PCA were measured to identify factors important to effective PCA use.MethodsPreoperatively, young (mean age +/- SD, 39 +/- 9 yr; n = 45) and older (mean age +/- SD, 67 +/- 8 yr; n = 44) general surgery patients completed measures of attitudes toward and expectations of postoperative pain and PCA, psychological distress, health opinions, self-efficacy, and optimism. On the first 2 postoperative days, pain at rest and with movement and satisfaction with pain control were assessed using visual analog scales. Daily opioid intake was recorded. When PCA was discontinued, satisfaction and concerns about it were assessed.ResultsThe older patients expected less intense pain (P = 0.003) and preferred less information about (P = 0.02) and involvement in (P = 0.002) health care than young patients. There were no age differences with regard to pain at rest (P = 0.22) or with movement (P = 0.68). The older group self-administered less opioid than the young group (P = 0.0001) and received PCA for more days than the young group (P = 0.004). The groups did not differ in concerns about pain relief, adverse drug effects, including opioid addiction, and equipment use or malfunction. Satisfaction with PCA was high and did not differ between the groups.ConclusionsPatient-controlled analgesia use was not hindered by age differences in beliefs about postoperative pain and opioids. Younger and older patients attained comparable levels of analgesia and were equally satisfied with their pain control.
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