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New Survey Reveals Nurses and Patients See Limitations of Commonly Used Method of Postoperative Pain Management: Findings point to need for improved routes of administration for greater ease of use, comfort

Cherry Hill, NJ, February 13, 2007 – Despite the belief that intravenous patient-controlled analgesia pumps, also referred to as IV PCA, are a good way to deliver postoperative pain medication, nurses and surgical patients agreed that IV PCA can hinder patient care, recovery time and comfort.  The findings are from a new survey, which included 351 nurses and 507 patients, conducted for the American Society of PeriAnesthesia Nurses (ASPAN) in partnership with Ortho-McNeil, Inc.

An IV PCA pump, which tethers a patient to an IV pole and equipment through an IV line into the arm, is a common approach to managing postoperative pain in the hospital.  The vast majority of nurses, 98 percent, and patients, 78 percent, said they believed patient control of pain medication is a benefit of this delivery system. Sixty-three percent of nurses, however, and 56 percent of patients agreed that lack of mobility is a drawback of IV PCA, even though 61 percent of patients surveyed did not experience a problem with the poles, pumps and lines. Early mobility following surgery is an important factor in recovery for many surgical patients.

Additionally, nearly half of patients, 46 percent, agreed that drawbacks of IV PCA are  “discomfort with having a needle put in your arm” and the fact that IV PCA “requires a needle.”

While virtually all of the nurses surveyed, 99 percent, agreed that IV PCA is a good way to deliver postoperative pain relief,

  • 49 percent reported one to two programming errors per month,
  • 50 percent reported having experienced a needle stick injury,
  • 51 percent reported one to two interruptions in analgesia per month due to pump malfunctions, and
  • 62 percent reported up to five line infiltrations -- leakage of IV fluid into sub-cutaneous tissue -- per month.

"Providing excellent postoperative patient care, including effective pain management, is a priority for surgical nurses," said Maureen Iacono, BSN, RN, CPAN, Nurse Manager, Postanesthesia Care Unit, St. Joseph's Hospital, Syracuse, New York, and Past President, American Society of PeriAnesthesia Nurses. "Patient-activated analgesia has many advantages.  These survey results indicate new approaches that enhance patient comfort and facilitate mobility are desirable."

Among the nurses surveyed, 84 percent said that having the option of a needle-free postoperative pain management system would improve their ability to care for their patients. Additionally, 62 percent of the nurses said they believed that if patients were offered the choice, most would choose a needle-free PCA over IV PCA. Surgery patients agreed: 79 percent said if they knew about this option, they would be likely to discuss it with their doctors.

In the United States, more than 23 million inpatient surgeries were performed in 2004 in non-federal, short-stay hospitals.  Studies have found that up to 75 percent of patients experience pain after surgery. Moderate, severe and extreme postoperative pain has been estimated to occur in up to 86 percent of patients following surgery.  Opioid analgesics such as morphine, fentanyl and oxycodone play a key role in the management of postoperative pain.  These drugs are administered through various routes.

About the survey
A total of 507 surgery patients, who underwent surgery from 2001 to 2006 and who required IV PCA , and 351 nurses who had administered or managed IV PCA for patients, were interviewed by telephone during August and September, 2006.    The margin of error for surgery patients is +/- 4.4 percent; for nurses, it is 5.2 percent.

The survey also included 250 Americans who have not had surgery (+/- 6.2 percent).  Data on this group is available upon request.

The survey was conducted by International Communications Research and was funded by Ortho-McNeil, Inc., in partnership with ASPAN.  Ortho-McNeil, Inc., which is headquartered in Raritan, N.J., provides innovative, high quality prescription treatments for health care providers and their patients in primary care settings, hospitals and other care facilities.

The American Society of PeriAnesthesia Nurses (ASPAN) is the international professional specialty nursing organization representing the interests of over 55,000 nurses practicing in preanesthesia and postanesthesia care, ambulatory surgery, and pain management.  

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