Comparing effects of intravenous patient-controlled analgesia and intravenous injection in patients who have undergone total hysterectomy

Aims and objectives: To compare the effects of two pain management methods, intravenous patient-controlled analgesia and conventional intravenous injection, in terms of pain level, adverse reactions experienced, nursing care time spent for pain management, satisfaction with pain management and total cost of pain management for patients who underwent total abdominal hysterectomy. Background: Patient-controlled intravenous analgesia has been used most commonly for management of postoperative pain. Although it can be very effective in management of postoperative pain, patients still complained of many adverse reactions. Design: A quasi-experimental study design was used. Methods: Seventy female participants were recruited for each group and were randomly assigned to one of the pain management methods. Data regarding pain level, adverse reactions experienced and level of satisfaction with pain management methods during a 48-hour postoperative period were collected. Calculation of cost for each pain management method was based on the cost of the device, drugs for both analgesics and antiemetics, and time spent by nurses for both pain management methods. Frequencies, percentages and means of the data were calculated, and chi-squared test and t-test were performed for homogeneity. Results: Mean postoperative pain levels at 2, 6 and 12 hour were significantly lower in patients who used patient-controlled analgesic compared with patients who received intravenous injection; however, after that, there was no significant difference between the two methods. The cost for pain management was much higher for patients who used patient-controlled analgesic; however, satisfaction level with pain control was lower than that for patients who received intravenous injection. Conclusions: For patients who underwent total hysterectomy, patient-controlled analgesia was not cost-effective for management of postoperative pain for 48 hour, compared with conventional intravenous injection. Relevance to clinical practice: For nurses caring for patients with pain, adaptation of diverse methods of pain management that will increase patients' satisfaction with pain management as well as lower the cost and occurrence of adverse reactions should be considered.