Management of patient-controlled analgesia: A comparison of primary surgeons and a dedicated pain service

Brett R. Stacey, Thomas E. Rudy, Danita Nellhaus

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Although Patient-Controlled Analgesia (PCA) is routinely available in most hospitals in the United States, there appears to be little standardization regarding who provides this valuable service to postoperative patients. This study evaluates the differences in PCA management practices and patient outcomes between primary service (PS) physicians and acute pain service (APS) physicians. Over a 3-mo period, 40 patients prescribed PCA by PS physicians were prospectively studied without the knowledge of the physicians or nurses involved in PCA management. After collecting PS data, a proportionate stratified random sampling procedure was used to select 40 APS patients matched for gender, age, and type of surgery. Data regarding patient demographics, PCA prescription, changes in PCA orders, opioid consumption, reason for discontinuation of PCA, verbal analog scale pain scores, side effects, and post-PCA pain management were analyzed. Although pain scores were not different between groups, APS patients had fewer side effects, were more likely to receive a loading dose, had their PCA settings adjusted more often (P <0.05), and used more opioid. PS patients were more likely to receive intramuscular medications after PCA discontinuation (P <0.05). This study demonstrates potentially important PCA management differences between APS and PS physicians.

Original languageEnglish (US)
Pages (from-to)130-134
Number of pages5
JournalAnesthesia and Analgesia
Volume85
Issue number1
DOIs
StatePublished - 1997

Fingerprint

Patient-Controlled Analgesia
Pain
Pain Clinics
Physicians
Opioid Analgesics
Surgeons
Practice Management
Pain Measurement
Pain Management
Prescriptions
Nurses
Demography

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Management of patient-controlled analgesia : A comparison of primary surgeons and a dedicated pain service. / Stacey, Brett R.; Rudy, Thomas E.; Nellhaus, Danita.

In: Anesthesia and Analgesia, Vol. 85, No. 1, 1997, p. 130-134.

Research output: Contribution to journalArticle

Stacey, Brett R. ; Rudy, Thomas E. ; Nellhaus, Danita. / Management of patient-controlled analgesia : A comparison of primary surgeons and a dedicated pain service. In: Anesthesia and Analgesia. 1997 ; Vol. 85, No. 1. pp. 130-134.
@article{6b32757ef83443db8885c0c65f31b164,
title = "Management of patient-controlled analgesia: A comparison of primary surgeons and a dedicated pain service",
abstract = "Although Patient-Controlled Analgesia (PCA) is routinely available in most hospitals in the United States, there appears to be little standardization regarding who provides this valuable service to postoperative patients. This study evaluates the differences in PCA management practices and patient outcomes between primary service (PS) physicians and acute pain service (APS) physicians. Over a 3-mo period, 40 patients prescribed PCA by PS physicians were prospectively studied without the knowledge of the physicians or nurses involved in PCA management. After collecting PS data, a proportionate stratified random sampling procedure was used to select 40 APS patients matched for gender, age, and type of surgery. Data regarding patient demographics, PCA prescription, changes in PCA orders, opioid consumption, reason for discontinuation of PCA, verbal analog scale pain scores, side effects, and post-PCA pain management were analyzed. Although pain scores were not different between groups, APS patients had fewer side effects, were more likely to receive a loading dose, had their PCA settings adjusted more often (P <0.05), and used more opioid. PS patients were more likely to receive intramuscular medications after PCA discontinuation (P <0.05). This study demonstrates potentially important PCA management differences between APS and PS physicians.",
author = "Stacey, {Brett R.} and Rudy, {Thomas E.} and Danita Nellhaus",
year = "1997",
doi = "10.1097/00000539-199707000-00023",
language = "English (US)",
volume = "85",
pages = "130--134",
journal = "Anesthesia and Analgesia",
issn = "0003-2999",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Management of patient-controlled analgesia

T2 - A comparison of primary surgeons and a dedicated pain service

AU - Stacey, Brett R.

AU - Rudy, Thomas E.

AU - Nellhaus, Danita

PY - 1997

Y1 - 1997

N2 - Although Patient-Controlled Analgesia (PCA) is routinely available in most hospitals in the United States, there appears to be little standardization regarding who provides this valuable service to postoperative patients. This study evaluates the differences in PCA management practices and patient outcomes between primary service (PS) physicians and acute pain service (APS) physicians. Over a 3-mo period, 40 patients prescribed PCA by PS physicians were prospectively studied without the knowledge of the physicians or nurses involved in PCA management. After collecting PS data, a proportionate stratified random sampling procedure was used to select 40 APS patients matched for gender, age, and type of surgery. Data regarding patient demographics, PCA prescription, changes in PCA orders, opioid consumption, reason for discontinuation of PCA, verbal analog scale pain scores, side effects, and post-PCA pain management were analyzed. Although pain scores were not different between groups, APS patients had fewer side effects, were more likely to receive a loading dose, had their PCA settings adjusted more often (P <0.05), and used more opioid. PS patients were more likely to receive intramuscular medications after PCA discontinuation (P <0.05). This study demonstrates potentially important PCA management differences between APS and PS physicians.

AB - Although Patient-Controlled Analgesia (PCA) is routinely available in most hospitals in the United States, there appears to be little standardization regarding who provides this valuable service to postoperative patients. This study evaluates the differences in PCA management practices and patient outcomes between primary service (PS) physicians and acute pain service (APS) physicians. Over a 3-mo period, 40 patients prescribed PCA by PS physicians were prospectively studied without the knowledge of the physicians or nurses involved in PCA management. After collecting PS data, a proportionate stratified random sampling procedure was used to select 40 APS patients matched for gender, age, and type of surgery. Data regarding patient demographics, PCA prescription, changes in PCA orders, opioid consumption, reason for discontinuation of PCA, verbal analog scale pain scores, side effects, and post-PCA pain management were analyzed. Although pain scores were not different between groups, APS patients had fewer side effects, were more likely to receive a loading dose, had their PCA settings adjusted more often (P <0.05), and used more opioid. PS patients were more likely to receive intramuscular medications after PCA discontinuation (P <0.05). This study demonstrates potentially important PCA management differences between APS and PS physicians.

UR - http://www.scopus.com/inward/record.url?scp=0030759435&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030759435&partnerID=8YFLogxK

U2 - 10.1097/00000539-199707000-00023

DO - 10.1097/00000539-199707000-00023

M3 - Article

C2 - 9212135

AN - SCOPUS:0030759435

VL - 85

SP - 130

EP - 134

JO - Anesthesia and Analgesia

JF - Anesthesia and Analgesia

SN - 0003-2999

IS - 1

ER -