| Postoperative Pain Control using Intravenous Patient Controlled Analgesia in Cesarean Section and Hysterectomy. |
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Yeon Soo Jeon, Yong Shin Kim, Jin Deok Joo, Jang Hyeok In, Jin Woo Choi, Eu Jin Kang, Dae Woo Kim, Yong Gul Kim, Jung Ah Lee |
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Department of Anesthesiology and Pain Medicine, Saint Vincent Hospital, The Catholic University of Korea, Suwon, Korea. likewinds@vincent.cuk.ac.kr |
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| Abstract |
BACKGROUND
Postoperative pain degree is variable according to the site, type, and method of operation. This study compared the pain degree and amount of analgesics required among 3 types of operation.
METHODS
Ninety patients were selected that cesarean section (Group I, n = 30), open total hysterectomy (Group II, n = 30), laparoscopic total hysterectomy (Group III, n = 30) were scheduled. Patients received PCA with basal rate 2 ml/h, bolus 1 ml, lockout interval 5 min using fentanyl and ketorolac. We evaluated VAS at 30 min, 2, 6, 12, 18, 24, 36, 48 h postoperatively, demand of button and attempt of button, 6 hourly used amount of analgesics; side effects and degree of satisfaction after 24, 48 h postoperatively.
RESULTS
The rest VAS decreased below 30 at 6 hr in group I & II and at 2 hr in group III. More analgesics were needed for the first 6 hr compared with remained time in 3 groups (group I vs. group II vs. group III, P < 0.05). Total amount of analgesics including loading dose were fentanyl 1,536 +/- 342microgram, ketorolac 167 +/- 34 mg for group I; 1,212 +/- 215microgram, 132 +/- 30 mg for group II; 866 +/- 125microgram, 97 +/- 27 mg for group III (group I vs. group II vs. group III, P < 0.05).
CONCLUSIONS
The postoperative pain was painful as order of cesarean section, open total hysterectomy, and laparoscopic total hysterectomy. The pain was reduced 6 hr in laparotomy and 2 h in laparoscopy. |
| Key Words:
cesarean section; fentanyl; intravenous PCA; ketorolac; open and laparoscopic total hysterectomy; postoperative pain control |
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