Postoperative intravenous patient‐controlled analgesia improves pain management after subcutaneous implantable defibrillator implantation

Autor: Kenta Tsutsui, Yoshitaka Terazaki, Risa Kanai, Masako Ishii, Seika Ohno, Yoko Sasaki, Akira Kitamura, Daisuke Kudo, Wataru Sasaki, Naomichi Tanaka, Masataka Narita, Kazuhisa Matsumoto, Hitoshi Mori, Yoshifumi Ikeda, Takahide Arai, Shintaro Nakano, Ritsushi Kato
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of Arrhythmia, Vol 40, Iss 2, Pp 349-355 (2024)
Druh dokumentu: article
ISSN: 1883-2148
1880-4276
DOI: 10.1002/joa3.13006
Popis: Abstract Objective Postoperative pain is a major issue with subcutaneous implantable cardioverter defibrillators (S‐ICD). In 2020, we introduced intravenous patient‐controlled analgesia (IV‐PCA) in addition to the conventional, request‐based analgesia for postoperative pain control in S‐ICD. To determine the effect and safety, we quantitatively assessed the effect of IV‐PCA after S‐ICD surgery over conventional methods. Methods During the study period, a total of 113 consecutive patients (age, 50.1 ± 15.5 years: males, 101) underwent a de novo S‐ICD implantation under general anesthesia. While the postoperative pain was addressed with either request‐based analgesia (by nonsteroid anti‐inflammatory drugs, N = 68, dubbed as “PCA absent”) or fentanyl‐based IV‐PCA in addition to the standard care (N = 45, dubbed as “PCA present”). The degree of postoperative pain from immediately after surgery to 1 week were retrospectively investigated by the numerical rating scale (NRS) divided into four groups at rest and during activity (0: no pain, 1–3: mild pain, 4–6: moderate pain, 7–10: severe pain). Results Although IV‐PCA was removed on Day 1, it was associated with continued better pain control compared to PCA absent group. At rest, the proportion of patients expressing pain (mild or more) was significantly lower in the PCA present group from Day 0 to Day 4. In contrast to at rest, a better pain control continued through the entire study period of 7 days. No serious adverse events were observed. A few patients experienced nausea in both groups and the inter‐group difference was not found significant. Conclusion IV‐PCA suppresses postoperative pain in S‐ICD without major safety concerns.
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