Türkay Çakan1, A. Alptekin2, A. Ceyhan1, M. Bababalım1, R. Çetinbaş1, N. Ünal1

1S.B. Ankara Training and Research Hospital Anesthesiology and Reanimation Clinic
2S.S.K. Diskapi Training and Research Hospital Anesthesiology and Reanimation Clinic

Keywords: Postoperative analgesia, i.v. PCA, morphine HCI

Abstract

We compared the efficacy of two different i.v. PCA dose regimens in 47 patient from ASA I-III who underwent total knee and hip replacement. The patient were randomly allocated into two groups. In the postoperative period 23 patients in the bolus group (Group 1) were received 1 mg bolus morphine HCI with 5 min. lock-out interval. 24 patients in bolus + 0.3-0.5 mg. hr.-1 basal infusion group (Group 2) were received 1 mg bolus + 0.3-0.5 mg. hr.4 basal infusion with 5 min lock-out interval. Hemodynamic and respiratory parameters. pain scores. total morphine consumption and side effect were evaluated after loading doses and at 6th. 12th. 18th and 24th hours.
The pain scores in Group 2 were significantly lower than Group 1 at 18th and 24th hour (p<0.001. p<0.005). The arterial blood pressure and respiratory rates were decreased significantly after PCA (p<0.01, p<0.001) but hypotension or respiratory depression were not observed in groups. No significant differences were observed between the groups according to side effects. Knee replacement patients who were in Group 2 had significantly lower pain scores than the patients in Group 1 at 18th and 24th hours postoperatively (p<0.005, p<0.05).
As a result in hip replacement patients. PCA bolus is sufficient in pain relief but adding a basal infusion to i.v. PCA when compared with PCA bolus alone is more effective and reliable in knee replacement patients without any side effect.