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Factors Affecting Unused Remaining Volume of Intravenous Patient-controlled Analgesia in Patients Following Laparoscopic Gynecologic Surgery

Asian Nursing Research 2014³â 8±Ç 4È£ p.300 ~ 304
KMID : 1022320140080040300
±è°æ¿Á ( Kim Kyoung-Ok ) - Dongguk University Ilsan Hospital Department of Anesthesiology and Pain Medicine

³ëÁÖ¿ø ( Roh Ju-Won ) - Dongguk University Ilsan Hospital Department of Obstetrics and Gynecology
½ÅÀºÁß ( Shin Eun-Jung ) - Dongguk University Ilsan Hospital Division of Nursing
ÀÎÁØ¿ë ( In Jun-Yong ) - Dongguk University Ilsan Hospital Department of Anesthesiology and Pain Medicine
¼ÛÅÂÈÆ ( Song Tae-Hun ) - Dongguk University Ilsan Hospital Department of Obstetrics and Gynecology

Abstract

Purpose: This study was undertaken to evaluate the factors affecting the unused remaining volume of intravenous patient-controlled analgesia (IV PCA) in patients who had undergone laparoscopic gynecologic surgery.

Methods: We retrospectively collected patient records from pre-existing PCA log sheets from 98 patients. Surgical factors and IV PCA-related data including remaining volume, administration duration, early discontinuation (yes or no), and adverse reactions were recorded. Chi-square test, one-way analysis of variance, and multiple linear regression were applied for data analysis.

Results: The average age of the 98 patients was 40.0 ¡¾ 8.24 years. The incidence of postoperative nausea and vomiting (PONV) and early discontinuation were not statistically significant among the different surgical groups (p = .540 and p = .338, respectively). Twenty-eight patients wanted discontinuation of IV PCA and the remaining volume was 33.6 ¡¾ 7.8 mL (range 20?55 mL). The significant determinants of remaining volume were whether IV PCA was discontinued due to PONV and duration of surgery (p < .001). The surgical duration was inversely correlated with the remaining volume.

Conclusion: Early discontinuation of IV PCA due to PONV is a major contributing factor to wastage of medicine. Prevention and treatment of PONV is needed to encourage patients to maintain PCA use for pain control.
KeyWords

analgesia, patient-controlled, drug and narcotic control, linear models, medical waste, postoperative nausea and vomiting
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