Implementation of a piritramide based patient-controlled analgesia (PCA) as a standard of care for pain control in late abortion induction: A prospective cohort study from a patient perspective
Objective: To assess whether the implementation of patient-controlled analgesia (PCA) with piritramide using an automatic pump system under routine conditions is effective to reduce pain in late abortion inductions Study design: Prospective observational cohort study Setting: Patients requiring medi...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | European Journal of Obstetrics & Gynecology and Reproductive Biology: X |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590161323000765 |
| _version_ | 1797394860197543936 |
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| author | L. Tascón Padrón N.L.A. Emrich B. Strizek A. Gass C. Link T. Hilbert S. Klaschik W. Meissner U. Gembruch J. Jiménez Cruz |
| author_facet | L. Tascón Padrón N.L.A. Emrich B. Strizek A. Gass C. Link T. Hilbert S. Klaschik W. Meissner U. Gembruch J. Jiménez Cruz |
| author_sort | L. Tascón Padrón |
| collection | DOAJ |
| description | Objective: To assess whether the implementation of patient-controlled analgesia (PCA) with piritramide using an automatic pump system under routine conditions is effective to reduce pain in late abortion inductions Study design: Prospective observational cohort study Setting: Patients requiring medically indicated abortion induction from 14 weeks of pregnancy onwards between July 2019 and July 2020 at the department of Obstetrics and Prenatal Medicine of the Bonn University Hospital in Germany. Methods: Evaluation of pain management after implementation of a PCA system compared with previous nurse-controlled tramadol-based standard under routine conditions. Patients answered a validated pain questionnaire and requirement of rescue analgesics was assessed. Pain intensity and satisfaction were measured on a ten-point numeric rating scale. Main Outcome Measure Maximal pain intensity Results: Forty patients were included. Patients using Piritramide-PCA complained of higher pain sores than those in the standard group (6.90 (± 2.34) vs. 4.83 (± 2.87), (p < 0.05)). In both groups the level of satisfaction with the analgesia received was comparable (8.00 (± 2.45) vs 7.67 (± 2.62), (p = 0.7)). Patients in the PCA group suffered more nausea (63.2 % vs 30 % respectively, OR 4.0, 95 % CI 1.05–15.20, p < 0.05) and expressed more the desire for more analgesic support compared to the control group (OR 5.7 (1–33.25), p = 0.05). Conclusion: Women with abortion induction after 14 weeks of gestation suffer from relevant severe pain, which requires adequate therapy. However, addition of PCA does not seem to bring any advantage in patients undergoing this procedure. |
| first_indexed | 2024-03-09T00:25:53Z |
| format | Article |
| id | doaj.art-fe4f92a33e7845c88169bbc482645af9 |
| institution | Directory Open Access Journal |
| issn | 2590-1613 |
| language | English |
| last_indexed | 2024-03-09T00:25:53Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Journal of Obstetrics & Gynecology and Reproductive Biology: X |
| spelling | doaj.art-fe4f92a33e7845c88169bbc482645af92023-12-12T04:35:44ZengElsevierEuropean Journal of Obstetrics & Gynecology and Reproductive Biology: X2590-16132023-12-0120100251Implementation of a piritramide based patient-controlled analgesia (PCA) as a standard of care for pain control in late abortion induction: A prospective cohort study from a patient perspectiveL. Tascón Padrón0N.L.A. Emrich1B. Strizek2A. Gass3C. Link4T. Hilbert5S. Klaschik6W. Meissner7U. Gembruch8J. Jiménez Cruz9Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Venusberg-Campus 1, 53127 Bonn, GermanyDepartment of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Venusberg-Campus 1, 53127 Bonn, GermanyDepartment of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Venusberg-Campus 1, 53127 Bonn, GermanyDepartment of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, GermanyDepartment of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, GermanyDepartment of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, GermanyDepartment of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, GermanyDepartment for Anesthesiology and Intensive Care Medicine/Department of Palliative Care, University Hospital of Jena, 07740 Jena, GermanyDepartment of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Venusberg-Campus 1, 53127 Bonn, GermanyDepartment of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Corresponding author.Objective: To assess whether the implementation of patient-controlled analgesia (PCA) with piritramide using an automatic pump system under routine conditions is effective to reduce pain in late abortion inductions Study design: Prospective observational cohort study Setting: Patients requiring medically indicated abortion induction from 14 weeks of pregnancy onwards between July 2019 and July 2020 at the department of Obstetrics and Prenatal Medicine of the Bonn University Hospital in Germany. Methods: Evaluation of pain management after implementation of a PCA system compared with previous nurse-controlled tramadol-based standard under routine conditions. Patients answered a validated pain questionnaire and requirement of rescue analgesics was assessed. Pain intensity and satisfaction were measured on a ten-point numeric rating scale. Main Outcome Measure Maximal pain intensity Results: Forty patients were included. Patients using Piritramide-PCA complained of higher pain sores than those in the standard group (6.90 (± 2.34) vs. 4.83 (± 2.87), (p < 0.05)). In both groups the level of satisfaction with the analgesia received was comparable (8.00 (± 2.45) vs 7.67 (± 2.62), (p = 0.7)). Patients in the PCA group suffered more nausea (63.2 % vs 30 % respectively, OR 4.0, 95 % CI 1.05–15.20, p < 0.05) and expressed more the desire for more analgesic support compared to the control group (OR 5.7 (1–33.25), p = 0.05). Conclusion: Women with abortion induction after 14 weeks of gestation suffer from relevant severe pain, which requires adequate therapy. However, addition of PCA does not seem to bring any advantage in patients undergoing this procedure.http://www.sciencedirect.com/science/article/pii/S2590161323000765Late abortion inductionMedically-indicated termination of pregnancyObstetrical painPain managementPatient-controlled analgesia |
| spellingShingle | L. Tascón Padrón N.L.A. Emrich B. Strizek A. Gass C. Link T. Hilbert S. Klaschik W. Meissner U. Gembruch J. Jiménez Cruz Implementation of a piritramide based patient-controlled analgesia (PCA) as a standard of care for pain control in late abortion induction: A prospective cohort study from a patient perspective European Journal of Obstetrics & Gynecology and Reproductive Biology: X Late abortion induction Medically-indicated termination of pregnancy Obstetrical pain Pain management Patient-controlled analgesia |
| title | Implementation of a piritramide based patient-controlled analgesia (PCA) as a standard of care for pain control in late abortion induction: A prospective cohort study from a patient perspective |
| title_full | Implementation of a piritramide based patient-controlled analgesia (PCA) as a standard of care for pain control in late abortion induction: A prospective cohort study from a patient perspective |
| title_fullStr | Implementation of a piritramide based patient-controlled analgesia (PCA) as a standard of care for pain control in late abortion induction: A prospective cohort study from a patient perspective |
| title_full_unstemmed | Implementation of a piritramide based patient-controlled analgesia (PCA) as a standard of care for pain control in late abortion induction: A prospective cohort study from a patient perspective |
| title_short | Implementation of a piritramide based patient-controlled analgesia (PCA) as a standard of care for pain control in late abortion induction: A prospective cohort study from a patient perspective |
| title_sort | implementation of a piritramide based patient controlled analgesia pca as a standard of care for pain control in late abortion induction a prospective cohort study from a patient perspective |
| topic | Late abortion induction Medically-indicated termination of pregnancy Obstetrical pain Pain management Patient-controlled analgesia |
| url | http://www.sciencedirect.com/science/article/pii/S2590161323000765 |
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