Patient Controlled Anagesia
Pain management comparison in orthopaedics- patient controlled analgesia vs. femoral nerve blocks
Picot question
In adult patients with total hip or knee replacements, how effective is patient controlled analgesia pain management compared to femoral nerve block in controlling post operative pain within the first 24 hours after surgery?
Importance to the science of nursing Major knee or total hip surgery is associated with severe postoperative pain (Yeh, Yang, Chen, & Tsou, 2007). In this group it can result in increased morbidity due to negative physiological responses such as reduced pulmonary and bowel function, increased catabolism, hypercoagulability, …show more content…
Date
Source data base
Terms
Results
Kept Abstract
Kept articles for IR
10/28
PubMed
total knee, knee, femoral nerve block, analgesia, anesthesia, total hip, patient controlled analgesia total knee 22,729 hits, knee 110,504 hits, femoral nerve block 5,545 hits, analgesia 64,431 hits, anesthesia 273,159, total hip 32,538, patient controlled analgesia
7, 721
10
4
11/16
CINAHL
total knee, knee, femoral nerve block, analgesia, anesthesia, total hip, patient controlled analgesia total knee 6,546, knee 33,003 hits, femoral nerve block 811 hits, analgesia 12,708 hits, anesthesia 36,440, total hip 7,092, patient controlled analgesia 2,437
5
2
LaBonte 4
11/29
Academic Search Premier
total knee, knee, femoral nerve block, analgesia, anesthesia, total hip, patient controlled analgesia total knee 8,283 hits, knee 42,061 hits, femoral nerve block 1,077 hits, analgesia 16,163 hits, anesthesia
46, 190, total hip 11,281, patient controlled analgesia 2,077 …show more content…
Ongoing monitoring of patient 's perceived control and statistically partialling it out may be tried, although such a procedure could introduce other methodological problems such as response effects. Another possibility worth trying is telling the PCA patients that it may take a while before the medication is delivered when they press the device. Thus, future studies may benefit from using specific measures like the surgery related anxiety scales and specific postoperative pain report scales. While the attribution of observed differences to pain tolerance seems compelling, it is important to note that pain tolerance was not measured directly in the study. Future investigations should examine the tolerance hypothesis against other possible barriers it effective PCA use, such as fear of addiction, fear of overuse and side
Picot question
In adult patients with total hip or knee replacements, how effective is patient controlled analgesia pain management compared to femoral nerve block in controlling post operative pain within the first 24 hours after surgery?
Importance to the science of nursing Major knee or total hip surgery is associated with severe postoperative pain (Yeh, Yang, Chen, & Tsou, 2007). In this group it can result in increased morbidity due to negative physiological responses such as reduced pulmonary and bowel function, increased catabolism, hypercoagulability, …show more content…
Date
Source data base
Terms
Results
Kept Abstract
Kept articles for IR
10/28
PubMed
total knee, knee, femoral nerve block, analgesia, anesthesia, total hip, patient controlled analgesia total knee 22,729 hits, knee 110,504 hits, femoral nerve block 5,545 hits, analgesia 64,431 hits, anesthesia 273,159, total hip 32,538, patient controlled analgesia
7, 721
10
4
11/16
CINAHL
total knee, knee, femoral nerve block, analgesia, anesthesia, total hip, patient controlled analgesia total knee 6,546, knee 33,003 hits, femoral nerve block 811 hits, analgesia 12,708 hits, anesthesia 36,440, total hip 7,092, patient controlled analgesia 2,437
5
2
LaBonte 4
11/29
Academic Search Premier
total knee, knee, femoral nerve block, analgesia, anesthesia, total hip, patient controlled analgesia total knee 8,283 hits, knee 42,061 hits, femoral nerve block 1,077 hits, analgesia 16,163 hits, anesthesia
46, 190, total hip 11,281, patient controlled analgesia 2,077 …show more content…
Ongoing monitoring of patient 's perceived control and statistically partialling it out may be tried, although such a procedure could introduce other methodological problems such as response effects. Another possibility worth trying is telling the PCA patients that it may take a while before the medication is delivered when they press the device. Thus, future studies may benefit from using specific measures like the surgery related anxiety scales and specific postoperative pain report scales. While the attribution of observed differences to pain tolerance seems compelling, it is important to note that pain tolerance was not measured directly in the study. Future investigations should examine the tolerance hypothesis against other possible barriers it effective PCA use, such as fear of addiction, fear of overuse and side