Comparison of postoperative pain management using two patient‐controlled analgesia methods: nursing perspective

Abstract

AIM: To compare the effect of fentanyl iontophoretic transdermal system and morphine intravenous patient-controlled analgesia on the time-efficiency and convenience of postoperative patient care. BACKGROUND: Intravenous patient-controlled analgesia with morphine is effectively used to manage postoperative pain; however, it takes time to set up and administer. METHODS: Nurses evaluated patient-care tasks with fentanyl iontophoretic transdermal system and/or morphine intravenous patient-controlled analgesia in two phase IIIb studies (n = 1305) using a nurse ease-of-care questionnaire. A responder for time-efficiency and convenience responded with one of the top three positive choices on all items; for satisfaction, a responder chose one of the top two positive choices on both items. Data were collected between March 2004 and April 2005. FINDINGS: In both studies, greater proportions of nurses were responders for fentanyl iontophoretic transdermal system than for morphine intravenous patient-controlled analgesia, respectively, for time-efficiency [total hip replacement surgery, 80.9% (250/309) vs. 57.7% (172/298), P < 0.001; abdominal/pelvic surgery, 84.8% (162/191) vs. 57.7% (113/196), P < 0.001], convenience [total hip replacement surgery, 85.5% (271/317) vs. 64.1% (191/298), P < 0.001; abdominal/pelvic surgery, 89.2% (166/186) vs. 62.8% (123/196), P < 0.001], and satisfaction [total hip replacement surgery, 66.6% (247/371) vs. 33.3% (108/324), P < 0.001; abdominal/pelvic surgery, 67.4% (155/230) vs. 38.2% (84/220), P < 0.001]. Higher proportions of nurses favoured fentanyl iontophoretic transdermal system than morphine intravenous patient-controlled analgesia in both studies (P < 0.001). CONCLUSION: The fentanyl iontophoretic transdermal system appears to be simpler, easier to use, and more satisfactory for nurses than morphine intravenous patient-controlled analgesia.