Comparison of three parenteral injection methods for early postoperative pain control in patients with intravenous patient-controlled analgesia (IV PCA)

ABSTRACT

BACKGROUND: This study was performed to compare postoperative pain and sedation among meperidine 50 mg PRN intramuscular injection, meperidine 50 mg routine intramuscular injection and fentanyl 50microg routine intravenous injection at the end of surgery for early postoperative pain control in patients with intravenous patient-controlled analgesia (IV PCA). METHODS: In group P (n = 35), meperidine 50 mg was injected intramuscularly on request of patients. In group M (n = 35) and F (n = 35), meperidine 50 mg was injected intramuscularly or fentanyl 50microg was injected intravenously at the end of surgery, respectively. Pain score was measured with verbal rating scale (VRS; 0?10) at 30 min, 1 hr, and 6 hr, and sedation score was evaluated with Observer's assessment of alertness/sedation scale (OAA/S) at 30 min, and 1 hr after extubation. Additional fentanyl 50 microg was injected intravenously if patient requested pain control in group P and if VRS was higher than 5 point at 30 min after extubation or patients requested pain relief in group M and group F. RESULTS: Sedation scores of group M were higher than group P and group F. Group P had a higher VRS score than group M and group F at 30 min after extubation. Dose of additional fentanyl 50 microg injection was similar among three groups. CONCLUSIONS: Fentanyl 50microg intravenous injection at the end of surgery with additional fentanyl 50microg injection on patient's request may be good method for early pain control for IV-PCA patients.