Medicina 2002; 38 (11) 1078-1082

Clinic of Anesthesiology, Kaunas University of Medicine Hospital, Lithuania, ¹Department of Pediatric Anesthesia and Intensive Care, The Queen Silvia Children’s Hospital, Gothenburg, Sweden

Key words: pain management, postoperative, patient-controlled analgesia, morphine, child.

Summary. Objective. We aimed to evaluate the efficacy, morphine requirements and side effects in patients managed with patient-controlled analgesia postoperatively.

Methods. Eighty-seven patients, 7 to 22 (median 14) years of age, after orthopedic, abdominal or thoracic surgery, were studied retrospectively. All patients had a preset standard continuous morphine infusion of 10 μg/kg/h, 20 μg/kg bolus dose, 8 min lock-out time and 100 μg/kg/h maximal dose. All patients were additionally treated with non-steroidal anti-inflammatory drugs. Respiratory rate, pain intensity, morphine requirements and nausea/ vomiting were evaluated every 3 hours. Pain was assessed using 6-point scale (1-no pain, 6-the worst pain).

Results. Median time for pain management was 51 h. Median (range) used dose of morphine was 19.9 (4.9–75.2) μg/kg/h. Sixty-one percent of the patients had a mean pain score of 1 or 2, 26% – 3, 13% – 4 or 5. Nausea/ vomiting occurred in 78% of cases. Respiratory rate less than 10 breaths per min was observed in 5.7% of patients. No patient required opioid antagonist to treat respiratory depression.

Conclusions. In the majority of patients patient-controlled analgesia was effective and used doses of morphine were low. Though nausea/ vomiting was the most common side effect, decreased respiratory rate was observed in some patients. Regular patient evaluation for vital signs and side effects is recommended.

Received 26 September 2002, accepted 22 October 2002