A preliminary assessment of vital-signs-integrated patient-assisted intravenous opioid analgesia (VPIA) for postsurgical pain: a case series
Background
We developed a Vital-signs-integrated Patient-assisted Intravenous opioid Analgesia (VPIA) analgesic infusion pump, a closed-loop vital signs monitoring and drug delivery system which embodies in a novel algorithm that takes into account patients’ vital signs (oxygen saturation, heart rate). The system aims to allow responsive titration of personalized pain relief to optimise pain relief and reduce the risk of respiratory depression. Moreover, the system will be important to enable continuous monitoring of patients during delivery of opioid analgesia.Methods
Nineteen patients who underwent elective gynecological surgery with postoperative patient controlled analgesia (PCA) with morphine were recruited. The subjects were followed up from their admission to the recovery room/ ward for up to 24 hours until assessment of patient satisfaction on the VPIA analgesic infusion pump.Results
The primary outcome measure of incidence of oxygen desaturation showed all patients had at least one episode of oxygen desaturation (<95%) during the study period. Only 6 (31.6%) patients had oxygen desaturation that persisted for more than 5 minutes. The average percentage time during treatment that oxygen saturation fell below 95% was 4.6%. Fourteen (73.7%) out of 19 patients encountered safety pause, due to transient oxygen desaturation or bradycardia. The patients’ median IQR pain scores at rest and at movement after post-op 24 hours were 0.0 2.0 and 3.0 2.0 respectively. The average ± SD morphine consumption in the first 24 hours was 12.5 ± 7.1mg. All patients were satisfied with their experience with the VPIA analgesic infusion pump.Conclusions
We have demonstrated the potential of VPIA analgesic infusion pump to increase the safety and patient satisfaction by incorporating vital signs monitoring to intravenous opioid analgesia.
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On 22 May, 2020
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On 13 May, 2020
Received 09 May, 2020
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On 17 Mar, 2020
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Posted 14 Oct, 2019
On 07 Feb, 2020
Received 02 Feb, 2020
On 16 Jan, 2020
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Invitations sent on 26 Sep, 2019
On 26 Sep, 2019
On 04 Sep, 2019
On 03 Sep, 2019
On 03 Sep, 2019
On 06 Aug, 2019
Received 05 Aug, 2019
Received 01 Aug, 2019
On 24 Jul, 2019
On 21 Jul, 2019
On 19 Jul, 2019
Invitations sent on 19 Jul, 2019
On 19 Jul, 2019
On 16 Jul, 2019
On 16 Jul, 2019
On 05 Jul, 2019
A preliminary assessment of vital-signs-integrated patient-assisted intravenous opioid analgesia (VPIA) for postsurgical pain: a case series
On 22 May, 2020
On 21 May, 2020
On 21 May, 2020
On 13 May, 2020
Received 09 May, 2020
Invitations sent on 23 Apr, 2020
On 23 Apr, 2020
On 22 Apr, 2020
On 21 Apr, 2020
On 21 Apr, 2020
On 30 Mar, 2020
Received 29 Mar, 2020
Received 28 Mar, 2020
Invitations sent on 17 Mar, 2020
On 17 Mar, 2020
On 17 Mar, 2020
On 10 Mar, 2020
On 09 Mar, 2020
On 09 Mar, 2020
Posted 14 Oct, 2019
On 07 Feb, 2020
Received 02 Feb, 2020
On 16 Jan, 2020
Received 07 Oct, 2019
Invitations sent on 26 Sep, 2019
On 26 Sep, 2019
On 04 Sep, 2019
On 03 Sep, 2019
On 03 Sep, 2019
On 06 Aug, 2019
Received 05 Aug, 2019
Received 01 Aug, 2019
On 24 Jul, 2019
On 21 Jul, 2019
On 19 Jul, 2019
Invitations sent on 19 Jul, 2019
On 19 Jul, 2019
On 16 Jul, 2019
On 16 Jul, 2019
On 05 Jul, 2019
Background
We developed a Vital-signs-integrated Patient-assisted Intravenous opioid Analgesia (VPIA) analgesic infusion pump, a closed-loop vital signs monitoring and drug delivery system which embodies in a novel algorithm that takes into account patients’ vital signs (oxygen saturation, heart rate). The system aims to allow responsive titration of personalized pain relief to optimise pain relief and reduce the risk of respiratory depression. Moreover, the system will be important to enable continuous monitoring of patients during delivery of opioid analgesia.Methods
Nineteen patients who underwent elective gynecological surgery with postoperative patient controlled analgesia (PCA) with morphine were recruited. The subjects were followed up from their admission to the recovery room/ ward for up to 24 hours until assessment of patient satisfaction on the VPIA analgesic infusion pump.Results
The primary outcome measure of incidence of oxygen desaturation showed all patients had at least one episode of oxygen desaturation (<95%) during the study period. Only 6 (31.6%) patients had oxygen desaturation that persisted for more than 5 minutes. The average percentage time during treatment that oxygen saturation fell below 95% was 4.6%. Fourteen (73.7%) out of 19 patients encountered safety pause, due to transient oxygen desaturation or bradycardia. The patients’ median IQR pain scores at rest and at movement after post-op 24 hours were 0.0 2.0 and 3.0 2.0 respectively. The average ± SD morphine consumption in the first 24 hours was 12.5 ± 7.1mg. All patients were satisfied with their experience with the VPIA analgesic infusion pump.Conclusions
We have demonstrated the potential of VPIA analgesic infusion pump to increase the safety and patient satisfaction by incorporating vital signs monitoring to intravenous opioid analgesia.
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Figure 4