COMPARISON BETWEEN PATIENT-CONTROLLED ANALGESIA AND INTRA-MUSCULAR MEPERIDINE AFTER THORACOTOMY

A prospective randomized controlled study was performed to assess the efficacy and safety of patient-controlled analgesia (PCA) in patients undergoing thoracotomy. This method was compared with a conventional p ain management technique consisting of regularly scheduled im injectio ns of analgesics. Forty adult patients were randomly assigned to recei ve intravenous PCA or im meperidine treatment over a 48-hr period afte r surgery. Care was taken to optimize analgesia in patients of both gr oups. The McGill Pain Questionnaire, visual analogue and verbal-numeri c scales were administered at regular intervals to measure various com ponents of the patients' pain experience, degree of pain relief advers e side effects and overall treatment efficacy. Functional recovery aft er surgery was also examined. The results showed good and comparable a nalgesia with both pain-control methods. However, a greater number of patients receiving im injections required dosage adjustments than in t he PCA group. Patients' and nurses' evaluations of overall treatment e fficacy also favoured PCA treatment. There were no major group differe nces in the side effect profile. Recovery pattern was also comparable in the two groups except for the length of hospitalisation. There were fewer long-stay patients in the PCA than in the im group. Meperidine intake was similar in both groups but considerable interpatient variat ion was seen. In conclusion, PCA is a safe, effective and individualiz ed treatment method for controlling pain after thoracotomy. There appe ars to be some clinical advantages of PCA over im dosing regimens for analgesia after thoracotomy.