Differences in Incidence of Common Side Effects Between Young Adults and Elderly Patients While Using IV-PCA
Differences in Incidence of Common Side Effects Between Young Adults and Elderly Patients While Using IV-PCA
In this retrospective study, postoperative pain score, PCA-related complications, the risk
 factors for requirement of rescue analgesics and antiemetics will be evaluated in young and
 elderly patients, respectively, using fentanyl-based IV PCA during postoperative 48 hours
 after various surgeries.
Since 2010, A PCA service team in the investigators' hospital have collected
 multidisciplinary clinical data from all the patients who used IV-PCA postoperatively in aim
 of the assessment of clinical outcome. The investigators reviewed the collected data from the
 patients who had used IV-PCA for pain control after an elective surgery under general or
 spinal anesthesia between Sep. 2010 and March. 2014. The need for informed consent was waived
 for this study. The investigators have used a disposable PCA pump (Ambix Anaplus®; E-Wha
 Fresenius Kabi, Korea or accufuser plus®; Woo Young Medical, Korea) and fentanyl was diluted
 in 100mL with saline for 48 hrs PCA infusion. The pump was set as follows: infusion rate as 2
 ml/hr, bolus dose as 0.5 ml or 1 ml, lockout time as 15 min. It was decided at the
 anesthesiologist's option whether the additional analgesic drug (ketorolac or nefopam) and
 the antiemetic drug (ondansetron, ramosetron or palonosetron) would be added in PCA or not.
 The anesthesiologist who performed the anesthesia decided the amount of chosen drugs.
 Exclusion criteria were as following: age < 20 years old, age 40 to 69, postoperative
 ventilator support or intensive care, and imperfect data. The data of the PCA regimen which
 has been decided were recorded and analyzed. Demographic variables including age, sex, body
 mass index, American Society of Anesthesiologists (ASA) physical status and history of
 smoking, motion sickness, postoperative nausea/vomiting, hypertension and diabetes mellitus
 have been analyzed. Anesthesia and surgery-related variables including the duration of
 anesthesia, the type of anesthesia (general or spinal), laparoscopy and the operation site
 (categorized in abdominal, thoracic, upper & lower extremities, head & neck, spine and
 others) were also been analyzed. PCA-related variables included total dose of fentanyl for
 two days (µg/kg), use of mixed additional analgesics and antiemetics in PCA and
 discontinuation of PCA. When the patient requested the discontinuation of IV-PCA, the reason
 and the time have been recorded. Postoperative variables including the numeric rating scale
 (NRS, 0-10, 0 = no symptom; 10= unthinkable worst pain) for pain, requirements of rescue
 analgesics and antiemetics were analyzed. And the postoperative complications including
 nausea, vomiting, headache, dizziness, and sedation were analyzed. All the postoperative
 variables were recorded at postoperative 0-6 hrs including stay at post-anesthesia care unit,
 6-12, 12-18, 18-24 and 24-48 hrs.
Inclusion Criteria:

 -  Patients who had used IV-PCA for pain control after an elective surgery under general
 or spinal anesthesia between Sep. 2010 and March. 2014

 Exclusion Criteria:

 -  Age < 20 years old,

 -  age 40 to 69,

 -  postoperative ventilator support or intensive care,

 -  and imperfect data