The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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Randomized Controlled Trial Comparative Study Clinical Trial
An evaluation of the effectiveness of patient-controlled analgesia after spinal surgery.
The purpose of this study was to evaluate the effectiveness of patient-controlled analgesia (PCA) in patients undergoing spinal surgery. Sixty patients undergoing spinal surgery were randomly assigned to receive PCA or the standard approach to postoperative analgesia (intramuscular injections on an "as needed" basis). ⋯ There were no differences between the groups in total daily analgesic intake, presence of adverse effects and length of hospital stay. These data suggest that PCA is a safe, effective approach to managing pain after spinal surgery.
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Some healthcare professionals continue to believe that patients experience minimal pain and discomfort after intracranial surgery. However, clinical experience indicates that many patients experience significant pain after craniotomy. ⋯ Inadequate pain control can be associated with a variety of negative physiological and psychological consequences. Neuroscience nurses are challenged to re-evaluate their current beliefs and practices related to pain and pain control after intracranial surgery.
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Multicenter Study Clinical Trial
Managing chronic nonmalignant pain with continuous intrathecal morphine.
One alternative to traditional treatment modalities for chronic pain is continuous intrathecal administration of morphine via an implanted pump. However, relatively little is known about the benefits and long-term complications of this therapy for chronic nonmalignant pain. The purpose of this study was to describe patient responses to continuous intrathecal morphine over the course of one year with respect to morphine dosage used, complications and subjective assessments of pain. ⋯ A statistically nonsignificant increase in the mean daily dosage of morphine occurred and few long-term adverse effects were present. Complications of implantation occurred in 33.3% of the patients and were successfully managed without discontinuing therapy. In selected patients with chronic pain, intrathecal administration of morphine via an implanted pump can reduce pain with minimal long-term adverse effects or complications.