Current postoperative pain control in Japan and the use of portable disposable infusors

Postoperative pain control is essential not only because it reduces the pai n experienced by patients, but also because it facilitates their recovery. Currently, postoperative continuous epidural analgesia (PCEA) is widely use d for postoperative pain control in Japan. Epidural analgesia is normally u sed with general anesthesia during the operation and PCEA. is used consecut ively. In 1997, Professor Hanaoka and his team conducted a nation-wide study in Ja pan on intraoperative and postoperative analgesia. Based on the 904 cases r esponding to a questionnaire, the results revealed that PCEA was effective in improving patients' quality of life and rate of recovery as well as in r educing pain. A retrospective investigation, by Dr. Hayashida, of cases undergoing major abdominal surgical operations in the University of Tokyo Hospital in 1995 a nd 1996 was performed. On classifying, the epidural analgesics were used in four groups, i.e., local anesthetics alone, local anesthetics plus bupreno rphine, local anesthetics plus fentanyl, and local anesthetics plus morphin e. The group treated with local anesthetics plus morphine required analgesi cs significantly less frequently than other groups. PCEA is routinely performed in Japan due to the availability on the market of a wide range of portable disposable infusors which are easy to use, ligh tweight and relatively inexpensive. Currently, seven models from six manufa cturers are sold in Japan. The flow rate of infusors may vary under the inf luence of several factors. However, if the properties of the infusors are k nown, they can be used quite safely. As bacterial filters are 100% effectiv e in removing bacteria and do not reduce the now rate under ordinary condit ions, their use is recommended.