New concept of postoperative analgesia – patient-controlled analgesia Surgical treatment can release the primary lesion or deformity of the patient’s tissues and organs, but pain caused by surgical trauma and strong stimulation can become one of the main complications after surgery. Severe pain not only causes mental and physical trauma to the patient, but also causes circulatory and respiratory dysfunction and metabolic and endocrine dysfunction, and in serious cases, it affects the patient’s recovery process. For example, orthopedic surgery is relatively traumatic due to the richness of nerve endings in the joint capsule and periosteum, so traditional analgesic methods such as oral analgesic drugs are difficult to achieve satisfactory efficacy, and intermittent intramuscular injection or static pushing of narcotic analgesics are not the most ideal analgesic methods. According to physiological, psychological, pharmacokinetic and therapeutic studies, patient-controlled analgesia (PCA) has been widely used in clinical practice as one of the most effective methods to meet the analgesic needs of patients. What is PCA? PCA is patient-controlled analgesia, which uses a PCA pump to continuously inject analgesic drugs into the patient’s body from the vein or epidural to complete analgesic treatment. The patient can press the patient-controlled button when he/she feels pain in the process (press and hold for 5 seconds each time, at least 15 minutes interval), and the appropriate dose of medicine will be added into the body, and the patient decides the number of times to use the self-control button according to the need of pain relief, so as to make the analgesic effect more perfect. The advantages of analgesic pump (PCA pump) 1. The use of analgesic pump can relieve patients’ pain timely, rapidly and effectively, and the analgesic effect is basically satisfactory. 2. It is beneficial to inhibit the overly strong stress reaction of the organism, accelerate the recovery of immune function of patients and reduce the occurrence of complications. 3. Facilitate patients’ cough and sputum discharge, improve respiratory function and maintain stable circulatory function. 4. It helps patients to fully cooperate with treatment, eat early, increase nutrition, promote early recovery, and reduce the burden of family and society. Indications for use 1. Pre-operative analgesia: Many patients have heavy injuries, such as fractures of limbs, trunk, pelvis, etc., as well as multiple and compound injuries. Such patients are in great pain before undergoing surgery, and we can configure PCA pumps for them to relieve pain, improve rest and sleep, and increase their ability to tolerate surgery. 2. Post-operative analgesia: For orthopedic surgery, open-heart surgery and other more traumatic surgeries, the pain of patients after surgery is usually severe. The use of analgesic pump for analgesic treatment can make the postoperative recovery smoother. 3. Functional exercise: Many patients often have to carry out restorative exercise in order to restore the function of joints and muscles, which usually causes patients to suffer a lot of pain, so that patients can easily carry out functional exercise in a basically pain-free state. 4. Severe soft tissue injury or patients who do not need surgical treatment can also choose PCA pump. IV. Management In order to ensure that every patient has a satisfactory analgesic effect, there is an Acute Pain Treatment Team (APST) in the Department of Anesthesiology, which is composed of several senior physicians and nurses who patrol patients in the morning, afternoon and night every day to observe the analgesic effect of patients. V. Possible problems in the use of PCA So far, some patients, their families and even some surgeons in the operation department still hold a wrong concept that postoperative pain should be normal and need not be dealt with, and that the use of postoperative analgesia will affect wound healing and recovery of gastrointestinal function. This is an extremely fallacious concept that needs to be gradually changed by active promotion of anesthesiologists and improvement of the quality of all people. Due to the existence of individual differences, special physical constitution (excessive alcohol consumption, long-term medication, etc.) and special postoperative position, elastic bandage fixation of the affected limb, etc., there may be poor results or more obvious side effects, please do not worry and contact the Department of Anesthesiology immediately, we can be on hand to solve the problem in time by changing the type, dose and infusion speed of analgesic drugs. When you or your relatives are suffering from post-operative pain or discomfort, anesthesiologists can help you get through it!