일개 대학병원에서의 Patient Controlled Analgesia 적용 환자의 수술 후 통증 관리 현황

Postoperative Pain Management Status of Patient Controlled Analgesia in a Single University Hospital

Purpose: This study aimed to investigate the current status of pain management in patients using patient-controlled analgesia (PCA) after surgery and to explore systematic PCA management strategies and effective pain control measures. Methods: Data were collected from adult patients aged 19 years or older who underwent surgery and received postoperative PCA management within 48 hours at S University Hospital in Gyeonggi Province between January 2020 and December 2022. The data were analyzed using descriptive statistical methods. Results: A total of 19,787 patients used PCA within 48 hours after surgery, with 60.7% being female. Intravenous PCA was the most commonly used route (96.6%), and fentanyl monotherapy was the most frequently used analgesic (71.8%). PCA effectively controlled pain in 82.8% of patients; however, 20.3% experienced side effects such as nausea, vomiting, and dizziness. Interventions for these side effects included the administration of antiemetics (24.2%), adjustments to PCA settings (3%), discontinuation or removal of PCA (1.9%), and re-education on PCA use (1.5%). PCA-related errors totaled 14 cases (0.07%) and involved either mechanical or human errors. Conclusion: A systematic PCA management team is essential for continuous monitoring of patients using PCA after surgery. Such a team is expected to facilitate effective pain control, enhance patient safety, and ensure high-quality nursing care.