수술 후 자가통증조절요법 중단 관련요인

Abstract

Purpose: The purpose of this study was to identify the factors associated with the discontinuation of patient controlled analgesia (PCA) after surgery. Methods: The data of 1,092 adult patients that were over 20 years of age and underwent PCA after surgery in the Gachon University Hospital from May 1 to June 30, 2017, were collected through the patients’ Electronic Medical Record (EMR). The collected data was analyzed via the use of the Chi-test, t-test and multivariate logistic regression analysis using SPSS 18.0 program. Results: The postoperative PCA discontinuation rate was 26.1%. It was associated with various symptoms, such as those of nausea, dizziness, and headache. The PCA discontinuation was also related with female (odds ratio, OR = 1.75; confidence interval, CI = 1.09- 2.82),nausea(OR=105.27;CI=61.03-181.58),total intravenousanesthesia(TIVA)ofthethyroidectomy(OR=10.43;CI=5.01-21.70). Conclusion: It is necessary to provide additional medication and nursing interventions to reduce nausea, which is the symptom as- sociated with PCA discontinuation, especially in the operation of female subjects and thyroidectomy under TIVA. That is, those who are at a high risk for PCA discontinuation should be able to administer additional antiemetics or reduce non medication nursing inter- ventions.