Postoperative intravenous patient-controlled analgesia improves pain management after subcutaneous implantable defibrillator implantation
© 2024 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:40 |
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| Enthalten in: |
Journal of arrhythmia - 40(2024), 2 vom: 28. Apr., Seite 349-355 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tsutsui, Kenta [VerfasserIn] |
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| Links: |
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| Themen: |
Implantable cardioverter defibrillator (ICD) |
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| Anmerkungen: |
Date Revised 09.04.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1002/joa3.13006 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370762576 |
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| 245 | 1 | 0 | |a Postoperative intravenous patient-controlled analgesia improves pain management after subcutaneous implantable defibrillator implantation |
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| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2024 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society. | ||
| 520 | |a 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 | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 520 | |a Conclusion: IV-PCA suppresses postoperative pain in S-ICD without major safety concerns | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a implantable cardioverter defibrillator (ICD) | |
| 650 | 4 | |a intravenous patient‐controlled analgesia (IV‐PCA) | |
| 650 | 4 | |a subcutaneous ICD (S‐ICD) | |
| 700 | 1 | |a Terazaki, Yoshitaka |e verfasserin |4 aut | |
| 700 | 1 | |a Kanai, Risa |e verfasserin |4 aut | |
| 700 | 1 | |a Ishii, Masako |e verfasserin |4 aut | |
| 700 | 1 | |a Ohno, Seika |e verfasserin |4 aut | |
| 700 | 1 | |a Sasaki, Yoko |e verfasserin |4 aut | |
| 700 | 1 | |a Kitamura, Akira |e verfasserin |4 aut | |
| 700 | 1 | |a Kudo, Daisuke |e verfasserin |4 aut | |
| 700 | 1 | |a Sasaki, Wataru |e verfasserin |4 aut | |
| 700 | 1 | |a Tanaka, Naomichi |e verfasserin |4 aut | |
| 700 | 1 | |a Narita, Masataka |e verfasserin |4 aut | |
| 700 | 1 | |a Matsumoto, Kazuhisa |e verfasserin |4 aut | |
| 700 | 1 | |a Mori, Hitoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Ikeda, Yoshifumi |e verfasserin |4 aut | |
| 700 | 1 | |a Arai, Takahide |e verfasserin |4 aut | |
| 700 | 1 | |a Nakano, Shintaro |e verfasserin |4 aut | |
| 700 | 1 | |a Kato, Ritsushi |e verfasserin |4 aut | |
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