Smart technology improves patient-controlled analgesia: A preliminary report

Citation
H. Rudolph et al., Smart technology improves patient-controlled analgesia: A preliminary report, ANESTH ANAL, 89(5), 1999, pp. 1226-1232
Citations number
21
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Journal title
ANESTHESIA AND ANALGESIA
ISSN journal
0003-2999 → ACNP
Volume
89
Issue
5
Year of publication
1999
Pages
1226 - 1232
Database
ISI
SICI code
0003-2999(199911)89:5<1226:STIPAA>2.0.ZU;2-Z
Abstract
A new adaptive system has been designed to improve patient-controlled analg esia through the use of a variable bolus dose and a variable background inf usion of analgesic. A novel hand set allows patients to rate their own pain on a linear scale of 1 to 10. Data derived from the hand set signals are u sed by an expert algorithm to repeatedly adapt the drug dosage of the bolus and of the background infusion according to both current pain intensity an d the patient's response to previous dosage. To test the system, we perform ed a small pilot clinical study, using a randomized, double-blinded, cross- over design. The new system was alternated with a conventional system every 12 h. Use of the new system was associated with significantly lower pain s cores and fewer bolus requests but more analgesic administration, though wi thout increased adverse effects. It was very well accepted by both patients and clinical staff. Implications: Pain relief after surgery is often best provided by patient-controlled analgesia, which uses an IV infusion pump an d a patient-activated switch. We have developed a new computer-controlled o r "smart" patient-controlled analgesia that rapidly learns a patient's indi vidual needs and provides continuously tailored pain relief.