BENEFITS OF IV-PCA

BENEFITS OF IV-PCA

The benefits of IV-PCA are best summarized in a meta-analysis of
randomized controlled trials published by Ballantyne et a12 in 1993.9 This
meta-analysis assimilated data from 15 randomized controlled trials
involving 787 adults undergoing various operative procedures comparing
IV-PCA versus IM injections. These data demonstrate greater analgesic
efficacy with IV-PCA: 5.6 on a scale of 0 to 100 mm (P=0.006).
Although this is not a huge difference in analgesic efficacy, I suspect
that if pain scores were assessed more frequently, a greater difference
might be demonstrated. Also, pain scores were assessed at rest and not
with mobilization. The greatest advantage of IV-PCA over IM injections
demonstrated in this meta-analysis was greater patient satisfaction: 42%
difference between satisfaction versus dissatisfaction (P = 0.002); however,
this meta-analysis did not demonstrate any difference in analgesic
use, length of hospital stay, or occurrence of any side effects. We can
conclude from this meta-analysis that IV-PCA provides better analgesia
and greater satisfaction in comparison to IM opioids, but there is little
rationale nor scientific evidence to suggest that IV-PCA improves outcome.