The effect of newly designed dual-channel elastomeric pump for intravenous patient-controlled analgesia after total laparoscopic hysterectomy: a randomized, double-blind, prospective study
Abstract Background A newly designed intravenous patient-controlled analgesia (PCA) device with a dual-channel elastomeric infusion pump has been recently introduced. One channel is a continuous line with a constant flow rate basal infusion, while the other channel has an adjustable flow rate and bo...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-10-01
|
| Series: | Perioperative Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13741-022-00282-z |
| _version_ | 1798029920902840320 |
|---|---|
| author | Seok Kyeong Oh Heezoo Kim Young Sung Kim Chung Hun Lee Jung Suk Oh Dae Hui Kwon |
| author_facet | Seok Kyeong Oh Heezoo Kim Young Sung Kim Chung Hun Lee Jung Suk Oh Dae Hui Kwon |
| author_sort | Seok Kyeong Oh |
| collection | DOAJ |
| description | Abstract Background A newly designed intravenous patient-controlled analgesia (PCA) device with a dual-channel elastomeric infusion pump has been recently introduced. One channel is a continuous line with a constant flow rate basal infusion, while the other channel has an adjustable flow rate and bolus function and is labeled as a selector-bolus channel. This study compared dual and single-channel intravenous PCA in terms of clinical effect and quality of recovery. Methods Eighty-four patients undergoing total laparoscopic hysterectomy were randomly allocated to a 1-channel group (n = 41) or a 2-channel group (n = 43). Only the selector-bolus channel was utilized, but the continuous channel was not utilized in the 1-channel group, but both channels were utilized in the 2-channel group. In the 1-channel group, 16 μg/kg of fentanyl, 2 mg/kg of ketorolac, and 12 mg of ondansetron with normal saline were administered to the selector-bolus channel and normal saline only in the continuous channel for blinding. In the 2-channel group, 16 μg/kg of fentanyl was administered to the selector-bolus channel, and ketorolac (2 mg/kg) and ondansetron (12 mg) were administered via the continuous channel. The quality of recovery was evaluated preoperatively and 24 h postoperatively using the Quality of Recovery-40 (QoR-40). Cumulative PCA consumption, postoperative pain rated using the numeric rating scale (NRS; during rest/cough), and postoperative nausea were evaluated 6, 12, 24, 36, and 48 h after surgery. Incidence of vomiting and use of antiemetics and rescue analgesics was measured. Results The 24-h postoperative QoR-40 score was higher in the 2-channel group than in the 1-channel group (P=0.031). The incidence of nausea at 12 h and 36 h was significantly higher in the 1-channel group (P=0.043 and 0.040, respectively), and antiemetic use was more frequent in the 1-channel group (P=0.049). Patient satisfaction was higher in the 2-channel group (P=0.036). No significant differences were observed in pain scores during resting/cough or cumulative PCA consumption. Conclusions The 2-channel PCA showed better patient satisfaction with higher QoR-40 during the recovery compared with the 1-channel PCA. Better satisfaction was associated with lower nausea and reduced rescue antiemetics by maintaining the infusion of adjuvant analgesic agents and antiemetic agents constantly by utilizing dual channels. Trial registration Registered at ClinicalTrials.gov , NCT04082039 on 9 September 2019. |
| first_indexed | 2024-04-11T19:31:45Z |
| format | Article |
| id | doaj.art-4d292e3994fb4be29eb14a9b3528862f |
| institution | Directory Open Access Journal |
| issn | 2047-0525 |
| language | English |
| last_indexed | 2024-04-11T19:31:45Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Perioperative Medicine |
| spelling | doaj.art-4d292e3994fb4be29eb14a9b3528862f2022-12-22T04:06:58ZengBMCPerioperative Medicine2047-05252022-10-0111111110.1186/s13741-022-00282-zThe effect of newly designed dual-channel elastomeric pump for intravenous patient-controlled analgesia after total laparoscopic hysterectomy: a randomized, double-blind, prospective studySeok Kyeong Oh0Heezoo Kim1Young Sung Kim2Chung Hun Lee3Jung Suk Oh4Dae Hui Kwon5Department of Anaesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of MedicineDepartment of Anaesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of MedicineDepartment of Anaesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of MedicineDepartment of Anaesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of MedicineDepartment of Anaesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of MedicineDepartment of Obstetrics and Gynecology, Bucheon Sejong HospitalAbstract Background A newly designed intravenous patient-controlled analgesia (PCA) device with a dual-channel elastomeric infusion pump has been recently introduced. One channel is a continuous line with a constant flow rate basal infusion, while the other channel has an adjustable flow rate and bolus function and is labeled as a selector-bolus channel. This study compared dual and single-channel intravenous PCA in terms of clinical effect and quality of recovery. Methods Eighty-four patients undergoing total laparoscopic hysterectomy were randomly allocated to a 1-channel group (n = 41) or a 2-channel group (n = 43). Only the selector-bolus channel was utilized, but the continuous channel was not utilized in the 1-channel group, but both channels were utilized in the 2-channel group. In the 1-channel group, 16 μg/kg of fentanyl, 2 mg/kg of ketorolac, and 12 mg of ondansetron with normal saline were administered to the selector-bolus channel and normal saline only in the continuous channel for blinding. In the 2-channel group, 16 μg/kg of fentanyl was administered to the selector-bolus channel, and ketorolac (2 mg/kg) and ondansetron (12 mg) were administered via the continuous channel. The quality of recovery was evaluated preoperatively and 24 h postoperatively using the Quality of Recovery-40 (QoR-40). Cumulative PCA consumption, postoperative pain rated using the numeric rating scale (NRS; during rest/cough), and postoperative nausea were evaluated 6, 12, 24, 36, and 48 h after surgery. Incidence of vomiting and use of antiemetics and rescue analgesics was measured. Results The 24-h postoperative QoR-40 score was higher in the 2-channel group than in the 1-channel group (P=0.031). The incidence of nausea at 12 h and 36 h was significantly higher in the 1-channel group (P=0.043 and 0.040, respectively), and antiemetic use was more frequent in the 1-channel group (P=0.049). Patient satisfaction was higher in the 2-channel group (P=0.036). No significant differences were observed in pain scores during resting/cough or cumulative PCA consumption. Conclusions The 2-channel PCA showed better patient satisfaction with higher QoR-40 during the recovery compared with the 1-channel PCA. Better satisfaction was associated with lower nausea and reduced rescue antiemetics by maintaining the infusion of adjuvant analgesic agents and antiemetic agents constantly by utilizing dual channels. Trial registration Registered at ClinicalTrials.gov , NCT04082039 on 9 September 2019.https://doi.org/10.1186/s13741-022-00282-zPatient-controlled analgesiaPostoperative nausea and vomitingHysterectomyPatient satisfactionQuality of recovery |
| spellingShingle | Seok Kyeong Oh Heezoo Kim Young Sung Kim Chung Hun Lee Jung Suk Oh Dae Hui Kwon The effect of newly designed dual-channel elastomeric pump for intravenous patient-controlled analgesia after total laparoscopic hysterectomy: a randomized, double-blind, prospective study Perioperative Medicine Patient-controlled analgesia Postoperative nausea and vomiting Hysterectomy Patient satisfaction Quality of recovery |
| title | The effect of newly designed dual-channel elastomeric pump for intravenous patient-controlled analgesia after total laparoscopic hysterectomy: a randomized, double-blind, prospective study |
| title_full | The effect of newly designed dual-channel elastomeric pump for intravenous patient-controlled analgesia after total laparoscopic hysterectomy: a randomized, double-blind, prospective study |
| title_fullStr | The effect of newly designed dual-channel elastomeric pump for intravenous patient-controlled analgesia after total laparoscopic hysterectomy: a randomized, double-blind, prospective study |
| title_full_unstemmed | The effect of newly designed dual-channel elastomeric pump for intravenous patient-controlled analgesia after total laparoscopic hysterectomy: a randomized, double-blind, prospective study |
| title_short | The effect of newly designed dual-channel elastomeric pump for intravenous patient-controlled analgesia after total laparoscopic hysterectomy: a randomized, double-blind, prospective study |
| title_sort | effect of newly designed dual channel elastomeric pump for intravenous patient controlled analgesia after total laparoscopic hysterectomy a randomized double blind prospective study |
| topic | Patient-controlled analgesia Postoperative nausea and vomiting Hysterectomy Patient satisfaction Quality of recovery |
| url | https://doi.org/10.1186/s13741-022-00282-z |
| work_keys_str_mv | AT seokkyeongoh theeffectofnewlydesigneddualchannelelastomericpumpforintravenouspatientcontrolledanalgesiaaftertotallaparoscopichysterectomyarandomizeddoubleblindprospectivestudy AT heezookim theeffectofnewlydesigneddualchannelelastomericpumpforintravenouspatientcontrolledanalgesiaaftertotallaparoscopichysterectomyarandomizeddoubleblindprospectivestudy AT youngsungkim theeffectofnewlydesigneddualchannelelastomericpumpforintravenouspatientcontrolledanalgesiaaftertotallaparoscopichysterectomyarandomizeddoubleblindprospectivestudy AT chunghunlee theeffectofnewlydesigneddualchannelelastomericpumpforintravenouspatientcontrolledanalgesiaaftertotallaparoscopichysterectomyarandomizeddoubleblindprospectivestudy AT jungsukoh theeffectofnewlydesigneddualchannelelastomericpumpforintravenouspatientcontrolledanalgesiaaftertotallaparoscopichysterectomyarandomizeddoubleblindprospectivestudy AT daehuikwon theeffectofnewlydesigneddualchannelelastomericpumpforintravenouspatientcontrolledanalgesiaaftertotallaparoscopichysterectomyarandomizeddoubleblindprospectivestudy AT seokkyeongoh effectofnewlydesigneddualchannelelastomericpumpforintravenouspatientcontrolledanalgesiaaftertotallaparoscopichysterectomyarandomizeddoubleblindprospectivestudy AT heezookim effectofnewlydesigneddualchannelelastomericpumpforintravenouspatientcontrolledanalgesiaaftertotallaparoscopichysterectomyarandomizeddoubleblindprospectivestudy AT youngsungkim effectofnewlydesigneddualchannelelastomericpumpforintravenouspatientcontrolledanalgesiaaftertotallaparoscopichysterectomyarandomizeddoubleblindprospectivestudy AT chunghunlee effectofnewlydesigneddualchannelelastomericpumpforintravenouspatientcontrolledanalgesiaaftertotallaparoscopichysterectomyarandomizeddoubleblindprospectivestudy AT jungsukoh effectofnewlydesigneddualchannelelastomericpumpforintravenouspatientcontrolledanalgesiaaftertotallaparoscopichysterectomyarandomizeddoubleblindprospectivestudy AT daehuikwon effectofnewlydesigneddualchannelelastomericpumpforintravenouspatientcontrolledanalgesiaaftertotallaparoscopichysterectomyarandomizeddoubleblindprospectivestudy |