Document Type : Original Article
Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
Department of Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran.
Background: Acute pain management has been a challenge for health professionals. We designed the present study to evaluate the effectiveness of pain control between intravenous patient-controlled analgesia (IV PCA) and conventional nurse-controlled analgesia (NCA) after coronary artery bypass graft (CABG) surgery concerning patient satisfaction during the postoperative period in the intensive care unit (ICU).
Methods: In this randomized clinical trial, 80 patients who underwent first-time elective CABG were enrolled by the convenience sampling method and were randomly allocated to 2 groups: PCA and NCA. PCA plus a continuous infusion of morphine was started immediately after the transfer of the patients to the ICU. NCA was based on the IV injections of morphine on demand. The level of pain was assessed using a numeric rating scale, and patient satisfaction was assessed using the pain treatment satisfaction scale. Further, sedation levels, morphine consumption, and side effects were evaluated from extubation until 48 hours after surgery. Additionally, nurses’ opinions regarding the PCA method were obtained.
Results: Numeric rating scale scores were higher in the NCA group than in the PCA group. Morphine consumption in the PCA group was significantly higher than that in the NCA group. Patient satisfaction was higher in the PCA group than in the NCA group (P<0.001). PCA was safe, and there were no differences in the incidence of serious adverse effects such as nausea and vomiting or respiratory depression.
Conclusions: In our patients, PCA with a background infusion of morphine increased morphine consumption and improved pain relief, without increasing side effects. It appears that NCA can be recommended for patients after CABG. (Iranian Heart Journal 2021; 22(4): 101-111)