Der Schmerz
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Many studies investigated patient-controlled analgesia (PCA) in the postoperative period in recovery rooms under anaesthesiologic monitoring but reports on the advantages and indications of PCA in surgical wards are scarce. The aim of this prospective study therefore was to investigate PCA as a routine technique in surgical wards. In particular we were interested in safety and in the efficacy of analgesia. ⋯ We conclude that PCA with piritramide is a safe technique when performed under routine conditions on surgical wards. However, standardized monitoring is mandatory. PCA leads to effective analgesia and consequently to greater comfort of surgical patients in the postoperative period. These conclusions hold only for patients with ASA status I-II who have undergone operations of the types listed above.
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PCAO (patient-controlled analgesia in outpatients) is a new treatment concept designed to overcome chronic or acute pain of cancer patients. From 1989 to 1992, a total of with tumour pain 204 patients were treated in the pain clinics of Fürth in cooperation with the Department of Radiation at the University Hospital in Regensburg. In 90 of these patients adequate oral medication was impossible because of problems in swallowing or blockage of the gastrointestinal tract, and subcutaneous opioid infusion over 24 h was therefore instituted. ⋯ PCAO for treatment of cancer patients at home yields freedom from of pain around the clock, independence, and quality of life with active personal involvement. The most important thing is that the patient can sleep during the night, as can the doctor, the nurse and relatives, as they do not need to give injections during the night. This new method of treating the pain of cancer patients at home in advanced disease is also well accepted by social security authorities, as it reduces the costs dramatically.