PCA pump


The therapy of post-operative pain is an important part of every surgical proccedure and with the development of therapeutic possibilities, the new, better and more effeicient ways such as the PCA pump are introduced.  

2019
patient controlled analgesia
post-operative pain managment
opioid
Published at: 21.5.2019

Review

Prof. Pavel Ševčík, MD, PhD
Expert Consultant of AKUTNĚ.CZ Head of Department of Anesthesiology and Intensive Care Medicine, University Hospital Ostrava, Faculty of Medicine University of Ostrava, Ostrava-Poruba, Czech Republic

This algorithm discusses another necessary topic – the management of intensive postoperative pain. A very accurate clinical example is chosen - mastectomy is one of the operations after which the post-operative pain can become chronic in a relatively high percentage of cases. Well-managed postoperative analgesia reduces the risk of chronic postmastectomy pain. The algorithm highlights the increasingly available and currently not fully utilized method of patient-controlled intravenous analgesia. It describes the use of the pump, the parameters that need to be set, as well as the choice of opioids that can be used for the PCA, including their dosing. At the same time, in one of its steps the algorithm recommends using gabapentinoids. The use of gabapentinoids is one of the current trends in the way of involving co-analgesics suitable for dealing with neuropathic pain in postoperative analgesia. Their utilisation, among other things, significantly reduces the dose of administered opioids and possibly shortens the period of their administration.

Sources

PHELPS, Pamela K. Smart infusion pumps: implementation, management, and drug libraries. Bethesda, Maryland: American Society of Health-System Pharmacists, 2011. ISBN 9781585282302.

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