Patient perspectives of patient-controlled analgesia (PCA) and methods for improving pain control and patient satisfaction.

BACKGROUND AND

OBJECTIVES

This study aimed to (1) identify patient-controlled analgesia (PCA) attributes that negatively impact patient satisfaction and ability to control pain while using PCA and (2) obtain data on patient perceptions of new PCA design features.

METHODS

We conducted a prospective survey study of postoperative pain control among patients using a PCA device. The survey was designed to evaluate patient satisfaction with pain control, understanding of PCA, difficulties using PCA, lockout-period management, and evaluation of new PCA design features.

RESULTS

A total of 350 eligible patients completed the survey (91%). Patients who had difficulties using PCA were less satisfied (P < 0.001) and were more likely to feel unable to control their pain (P < 0.001). Satisfaction and self-reported ability to control pain were not affected by patient education about the PCA. Forty-nine percent of patients reported not knowing if they would receive medicine when they pushed the PCA button, and of these, 22% believed that this uncertainty made their pain worse. The majority of patients preferred the proposed PCA design features for easier use, including a light on the button, making it easier to find (57%), and a PCA button that vibrates (55%) or lights up (70%), alerting the patient that the PCA pump is able to deliver more medicine.

CONCLUSIONS

A majority of patients, irrespective of their satisfaction with PCA, preferred a new PCA design. Certain attributes of current PCA technology may negatively impact patient experience, and modifications could potentially address these concerns and improve patient outcomes.