The Effect Of PCIA On Pain And Rehabilitation In Patients After Gynecological Laparotomy

Objective:Analysis the impact of patient controlled intravenous analgesia(PCIA) on postoperative pain intensity, comfort degree and recovery quality in patients undergoing gynecologic laparotomy.Methods:We reviewed 778 cases undergoing gynecological laparotomy with combined spinal-epidural anesthesia in our hospital from June 2014 to June 2015. According to the use of PCIA or not, these cases were categorized into 2 groups, the used group(S group)and unused group(F group). In each group, Verbal rating scales(VAS) and Bruggrmann comfort scale(BCS) were used to evaluate analgesic effect and comfort degree at 24 h and48h postoperatively and the Qo R-40 questionnaire(QoR-40) was recorded preoperatively and 1 to 3 days after surgery to assess the quality of recovery.Results:The VRS scores of S group were lower than F group at 24 h and 48 h postoperatively(P<0.05), the BCS scores were significantly higher(P<0.05). No differences were shown on the Qo R-40 score between two groups before surgery and on the third day postoperatively(P>0.05). While on the postoperative 1 to 2 days, the scores of Qo R-40 in G1 group were higher than that in G2 group(P<0.05), as well as the scores of pain and emotional state(P<0.05). The Physical comfort scores of both the two days were lowerin G1 group(P<0.05).Conclusion:PCIA has a dual effect on postoperative pain and rehabilitation in patients undergoing gynecological laparotomy. On the one hand, the application of PCIA can significantly reduce pain, increase comfort, and improve the quality of patients’ early recovery from the whole. On the other hand, the use of PCIA can reduce the patient’s physical comfort, and thus to a certain extent, affect the quality of patients’ recovery.