Circadian variation of IV PCA use in patients after orthognathic surgery - a retrospective comparative study
박수경, 지성인, 서광석, 김현정,
소속 상세정보
박수경 ( Park Soo-Kyung ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
지성인 ( Chi Seong-In ) - Seoul National University School of Dentistry Department of Dental Anesthesiology
서광석 ( Seo Kwang-Suk ) - Seoul National University School of Dentistry Department of Dental Anesthesiology
김현정 ( Kim Hyun-Jeong ) - Seoul National University School of Dentistry Department of Dental Anesthesiology
KMID : 0980320150150030141
Abstract
Background: An understanding of the features of postoperative pain is essential for optimal analgesic dosing strategies. Using a visual analogue scale (VAS) score and patient controlled analgesia (PCA) infusion pattern analysis, an anesthesiologist can estimate when and how severely patients suffer from pain. Several reports have been published about circadian changes in the pain threshold. Postoperative pain was analyzed retrospectively in 250 patients who underwent orthognathic surgery.
Methods: A total of 250 patients were allocated into two groups according to the time of recovery from anesthesia. Patients in the early group (group E) recovered from anesthesia before 06:00 p.m. Patients in the late group (group L) recovered from anesthesia after 06:00 p.m. All patients received intravenous patient controlled analgesia (IV PCA) at the end of the operation. The VAS score of pain intensity was measured. Self-administration of bolus analgesic from the IV PCA device was also analyzed according to actual time and elapsed time.
Results: VAS scores showed no difference between the two groups except 36 hours after recovery from anesthesia. On POD1, there were two peaks for self-administration of bolus analgesics in group L and one peak in the morning for group E. Two peaks each in the morning and in the afternoon were shown in both groups on POD2.
Conclusions: Diurnal variance in pain should be considered for effective dosing strategies.
키워드
Circadian; Orthognathic surgery; Patient controlled analgesia; Postoperative pain
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