The effectiveness of patient control analgesia in the treatment of acute traumatic pain in the emergency department: a randomized controlled trial.

INTRODUCTION: Pain seems to be one of the most frequent complaints in the emergency department, however pain control is often suboptimal as seen by many audits. We conducted a study to find out whether the use of patient control analgesia (PCA) is effective in controlling acute pain in the emergency department
METHODOLOGY: This was a randomized controlled trial conducted in the emergency departments of two tertiary centres over a period of 1 year. Patients were randomized into two groups. The study and the control groups were given analgesia through the PCA system and boluses of analgesia through titration method, respectively. Pain levels were measured using the Visual Analogue Scale at 15 min intervals. Any adverse events and total morphine dose for each group were recorded. Finally, within 24 h, these patients were given questionnaires regarding their experience with regards to pain relief encountered.
RESULTS: A total of 47 patients were enrolled. The Visual Analogue Score change over 120 min for PCA and Morphine bolus groups were 5.921 [SD±1.656] and 4.834 (SD±1.797), respectively (P<0.001). However the total dosage of morphine consumed by both groups were statistically insignificant; PCA 7.95 mg (SD±2.44) versus bolus 8.10 (SD±0.99) (P=0.06). The satisfaction questionnaire also revealed that the PCA group of patients was more satisfied using this method of pain relief.
CONCLUSION: PCA provides more effective pain relief and patient satisfaction when compared with the conventional method of bolus intravenous injection for the relief of traumatic pain in the emergency department setting.

RCT Entities:   Population Interventions Outcomes