Surgery is one of the main treatments for plastic surgery patients, but post-surgical pain is a major problem that has long plagued patients and surgeons. Severe pain not only causes circulatory, respiratory, digestive, and urinary dysfunction and neuroendocrine and metabolic dysfunction, but also leads to mental changes such as fear, restlessness, and irritability, which bring great trauma to the patient’s mind and body, and can affect the regression of disease in serious cases.
Traditional postoperative analgesia usually adopts intermittent intramuscular injection or static push of narcotic analgesics, which is not an ideal method of analgesia as proven by clinical practice. This is one of the most effective analgesic methods that meet the pain needs of patients based on the results of multiple studies on patient physiology, psychology, pharmacokinetics and pharmacodynamics, which can effectively eliminate postoperative pain and make you easily get through the difficult days after surgery, and is a new postoperative analgesic technology widely used all over the world. The Department of Anesthesiology of our hospital has many years of clinical experience in applying PCA pump to the pain treatment of postoperative patients, and the analgesic effect is good. In order to further improve the quality of service and let patients fully understand and choose this technology, the following aspects are introduced as follows.
1.Definition of patient-controlled analgesia (PCA): a kind of microcomputer analgesia produced by the close combination of computer technology and medicine, which is pre-programmed by anesthesiologists and safe limited amount of analgesics, and the patient himself controls the required analgesics intermittently through an easy-to-operate press-connector to quickly achieve post-operative pain relief or relief.
2.Specialized equipment for PCA: patient-controlled analgesic pump (PCA pump), whose structure includes.
(1) Silicone fluid reservoir capsule.
(2) Automatic switch.
(3) Hand-controlled switch.
3.Drug delivery route.
(1) intravenous (PCIA): the channel is connected to the intravenous drug delivery.
(2) Epidural (PCIA): the channel is connected in the epidural cavity to administer the drug.
(3) Subcutaneous (PCIA): the channel is connected to the subcutaneous drug delivery.
4, the drugs used in PCA: opioids: morphine, dulcolax, fentanyl, etc.; bupivacaine, lidocaine, etc.; opioids + local anesthetic drugs mixed.
5, the use of: generally do not need to resort to hand-controlled switch, automatic switch drug delivery can meet the needs of patients. However, individual patients with a low pain threshold can add a hand-controlled switch and decide the number of times to use the hand-controlled switch according to the needs of pain. (Patients can press the hand control switch by themselves without the participation of clinical staff)
6. Advantages of PCA.
(1) PCA administration is in line with the principle of pharmacokinetics of analgesic drugs, and it is easier to maintain the minimum effective analgesic concentration.
(2) The use of analgesic drugs is really timely and rapid, which basically solves the individual differences of patients’ needs for analgesic drugs.
(3) It facilitates patients to obtain the best pain relief effect at any moment and under different pain intensity.
(4) It alleviates the adverse effects caused by pain, such as stress, myocardial ischemia, pulmonary atelectasis and delayed functional exercise.
(5) Portable design, treatment is not restricted by body position and space.
(6) It is conducive to the full cooperation of postoperative patients with treatment and early activities, promoting early recovery and reducing the burden on families and society.
7, PCA use precautions.
(1) Strengthen the monitoring of blood pressure, pulse, respiration, patient pain level and sedation depth, and carefully record and deal with the problems in the process of use in a timely manner.
(2) Explain the use of PCA pump to patients and family members before and after surgery so that patient-controlled analgesia in the true sense can be carried out smoothly.
(3) Postoperative analgesia requires the cooperation of patients and family members. Pain is a very complex physiological and psychological process, so patients and family members should have confidence in the anesthesiologist and actively cooperate to achieve the best postoperative analgesic effect.