Abstract
Background: A newly designed intravenous patient-controlled analgesia (PCA) device with dual-channel elastomeric infusion pump has been recently introduced. One channel is a continuous line with a constant flow rate basal infusion, while the other channel has an adjustable flow rate and bolus function, and is labeled as a selector-bolus channel. This study compared dual and single channel intravenous PCA in terms of clinical effect and quality of recovery.Methods: Eighty-four patients undergoing total laparoscopic hysterectomy were randomly allocated to a 1-channel group (n = 41) or a 2-channel group (n = 43). Only the selector-bolus channel was utilised, but the continuous channel was not utilised in the 1-channel group, but both channels were utilised in the 2-channel group. In the 1-channel group, 16 µg/kg fentanyl, 2 mg/kg ketorolac, and 12 mg ondansetron with normal saline was administered to the selector-bolus channel, and normal saline only in the continuous channel for blinding. In the 2-channel group, 16 µg/kg fentanyl was administered to the selector-bolus channel, and ketorolac (2 mg/kg) and ondansetron (12 mg) were administered via the continuous channel. The quality of recovery was evaluated preoperatively and 24 h postoperatively using the Quality of Recovery-40 (QoR-40). Cumulative PCA consumption, postoperative pain rated using the numeric rating scale (NRS; during rest/cough), and postoperative nausea were evaluated 6, 12, 24, 36, and 48 hours after surgery. Incidence of vomiting and use of antiemetics and rescue analgesics were measured.Results: The 24-h postoperative QoR-40 score was higher in the 2-channel group than in the 1-channel group (P=0.031). The incidence of nausea at 12 h and 36 h was significantly higher in the 1-channel group (P=0.043 and 0.040, respectively), and antiemetic use was more frequent in the 1-channel group (P=0.049). Patient satisfaction was higher in the 2-channel group (P=0.036). No significant differences were observed in pain scores during resting/cough or cumulative PCA consumption.Conclusions: The 2-channel PCA showed a lower incidence of nausea and antiemetics administration, and consequently higher overall patient satisfaction and quality of recovery with comparable analgesic efficacy to that of the 1-channel PCA after total laparoscopic hysterectomy.Trial registration: Registered at ClinicalTrials.gov, NCT04082039 on 9 September 2019.
Comparison of the Analgesic Effect of Sufentanil versus Fentanyl in Intravenous Patient-Controlled Analgesia after Total Laparoscopic Hysterectomy: A Randomized, Double-blind, Prospective Study