Journal of pain and symptom management
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J Pain Symptom Manage · Jan 1991
Randomized Controlled Trial Comparative Study Clinical TrialEvaluation of patient-controlled analgesia (PCA) versus PCA plus continuous infusion in postoperative cancer patients.
The benefits of two dosing methods, patient-controlled analgesia (PCA) with morphine sulfate (MS) alone and PCA plus continuous infusion of morphine sulfate (PCA + CI) were clinically evaluated in a randomized, single-blinded study of 30 adult abdominal surgery patients. Doses were adjusted based on pain and sedation ratings. Respirations, pulse, blood pressure, pain and sedation ratings were assessed. ⋯ There seems to be a trend for the PCA + CI group to have less fluctuation in sedation between days and better pain control (as demonstrated by verbal and visual analog pain scores) on the third postoperative day. Statistical significance was not found, however. PCA plus continuous infusion of MS may be a beneficial approach to the management of postoperative pain in selected patients; studies to identify these patients need to be done.
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We treat cancer pain patients at their homes, in collaboration with their relatives and primary physician. Assistance is free. ⋯ In 118 patients treated with our model between October 1987 and December 1988, we assessed the symptoms that moved them to seek assistance, their previous therapies, and the effectiveness of our intervention. The data obtained suggest that (a) in our country, the majority of cancer patients do not obtain effective pain and symptom control; (b) our model yields satisfactory pain control and improvement in quality of life; and (c) there is a need for centers that teach and practice terminal care; our model may be useful as a working outline for such centers.