TY - JOUR
T1 - The safety and efficacy of parent-/nurse-controlled analgesia in patients less than six years of age
AU - Monitto, Constance L.
AU - Greenberg, Robert S.
AU - Kost-Byerly, Sabine
AU - Wetzel, Randall
AU - Billett, Carol
AU - Lebet, Ruth M.
AU - Yaster, Myron
PY - 2000
Y1 - 2000
N2 - Over the past 5 yr, we have treated nonsurgical and postoperative pain in children <6 yr of age by using a patient-controlled analgesia pump to deliver small-dose continuous IV opioid infusions supplemented by parent- and nurse-controlled opioid bolus dosing. We call this technique parent-/nurse-controlled analgesia (PNCA). Because the safety and efficacy of PNCA have not been previously evaluated, we have undertaken a prospective, 1-yr observational study to determine patient demographics, effectiveness of analgesia, and the incidence of complications (pruritus, vomiting, and respiratory depression) in patients receiving PNCA. Data were collected on 212 children (98 female) who were treated on 240 occasions with PNCA for episodes of pain. Patients averaged 2.3 ± 1.7 yr of age and 11 ± 5 kg, and received a median of 4 (range 2-54) days of PNCA therapy. Maximum daily pain scores were ≤3/10 (objective pain scale) or ≤2/5 (objective or self-report pain scale) in more than 80% of all occasions of PNCA use. PNCA usage was associated with an 8% incidence of pruritus and a 15% incidence of vomiting on the first day of treatment. Nine children studied received naloxone, four (1.7%) for treatment of PNCA-related apnea or desaturation. All had improvement in their symptoms after naloxone administration.
AB - Over the past 5 yr, we have treated nonsurgical and postoperative pain in children <6 yr of age by using a patient-controlled analgesia pump to deliver small-dose continuous IV opioid infusions supplemented by parent- and nurse-controlled opioid bolus dosing. We call this technique parent-/nurse-controlled analgesia (PNCA). Because the safety and efficacy of PNCA have not been previously evaluated, we have undertaken a prospective, 1-yr observational study to determine patient demographics, effectiveness of analgesia, and the incidence of complications (pruritus, vomiting, and respiratory depression) in patients receiving PNCA. Data were collected on 212 children (98 female) who were treated on 240 occasions with PNCA for episodes of pain. Patients averaged 2.3 ± 1.7 yr of age and 11 ± 5 kg, and received a median of 4 (range 2-54) days of PNCA therapy. Maximum daily pain scores were ≤3/10 (objective pain scale) or ≤2/5 (objective or self-report pain scale) in more than 80% of all occasions of PNCA use. PNCA usage was associated with an 8% incidence of pruritus and a 15% incidence of vomiting on the first day of treatment. Nine children studied received naloxone, four (1.7%) for treatment of PNCA-related apnea or desaturation. All had improvement in their symptoms after naloxone administration.
UR - http://www.scopus.com/inward/record.url?scp=0033864925&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033864925&partnerID=8YFLogxK
U2 - 10.1213/00000539-200009000-00014
DO - 10.1213/00000539-200009000-00014
M3 - Article
C2 - 10960379
AN - SCOPUS:0033864925
SN - 0003-2999
VL - 91
SP - 573
EP - 579
JO - Anesthesia and analgesia
JF - Anesthesia and analgesia
IS - 3
ER -