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Research article
A preliminary assessment of vital-signs-integrated patient-assisted intravenous opioid analgesia (VPIA) for postsurgical pain: a case series
Ban Leong SNG
KK Women's and Children's Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5374-4271
License:
This work is licensed under a CC BY 4.0 License. Read Full License
The most recent version of this article is available here.
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 embodied in a novel algorithm that took into account patients’ vital signs (oxygen saturation, heart rate). The system aimed to allow responsive titration of personalized pain relief to optimize pain relief and reduce the risk of respiratory depression. Moreover, the system would 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 at least 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 median percentage time during treatment that oxygen saturation fell below 95% was 1.9%. 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 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 The use of VPIA analgesic infusion pump, when integrated with continuous vital sign monitor and variable lockout algorithm, was able to provide pain relief with good patient satisfaction.
Keywords
infusion pump, postoperative pain, vital sign monitoring, oxygen desaturation
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Received 09 May, 2020
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On 23 Apr, 2020
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On 22 Apr, 2020
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On 21 Apr, 2020
Editor invited
On 21 Apr, 2020
Version 3
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Editorial decision: Major revision
On 30 Mar, 2020
Review #2 received
Received 29 Mar, 2020
Review #1 received
Received 28 Mar, 2020
Reviewers invited
Invitations sent on 17 Mar, 2020
Reviewer #1 agreed
On 17 Mar, 2020
Reviewer #2 agreed
On 17 Mar, 2020
Editor assigned
On 10 Mar, 2020
Submission checks complete
On 09 Mar, 2020
Editor invited
On 09 Mar, 2020
No comments provided
Editorial decision: Major revision
On 07 Feb, 2020
Review #2 received
Received 02 Feb, 2020
Reviewer #2 agreed
On 16 Jan, 2020
Review #1 received
Received 07 Oct, 2019
Reviewers invited
Invitations sent on 26 Sep, 2019
Reviewer #1 agreed
On 26 Sep, 2019
Editor assigned
On 04 Sep, 2019
Submission checks complete
On 03 Sep, 2019
Editor invited
On 03 Sep, 2019
No comments provided
Editorial decision: Major revision
On 06 Aug, 2019
Review #2 received
Received 05 Aug, 2019
Review #1 received
Received 01 Aug, 2019
Reviewer #3 agreed
On 24 Jul, 2019
Reviewer #2 agreed
On 21 Jul, 2019
Editor assigned
On 19 Jul, 2019
Reviewers invited
Invitations sent on 19 Jul, 2019
Reviewer #1 agreed
On 19 Jul, 2019
Submission checks complete
On 16 Jul, 2019
Editor invited
On 16 Jul, 2019
First submitted
On 05 Jul, 2019
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This preprint is under consideration at BMC Anesthesiology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
A preliminary assessment of vital-signs-integrated patient-assisted intravenous opioid analgesia (VPIA) for postsurgical pain: a case series
Ban Leong SNG
KK Women's and Children's Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5374-4271
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
No community comments so far
Editor assigned
On 22 May, 2020
Submission checks complete
On 21 May, 2020
Editor invited
On 21 May, 2020
No comments provided
Editorial decision: Minor revision
On 13 May, 2020
Review #1 received
Received 09 May, 2020
Reviewers invited
Invitations sent on 23 Apr, 2020
Reviewer #1 agreed
On 23 Apr, 2020
Editor assigned
On 22 Apr, 2020
Submission checks complete
On 21 Apr, 2020
Editor invited
On 21 Apr, 2020
Version 3
Posted 17 Mar, 2020
No comments provided
Editorial decision: Major revision
On 30 Mar, 2020
Review #2 received
Received 29 Mar, 2020
Review #1 received
Received 28 Mar, 2020
Reviewers invited
Invitations sent on 17 Mar, 2020
Reviewer #1 agreed
On 17 Mar, 2020
Reviewer #2 agreed
On 17 Mar, 2020
Editor assigned
On 10 Mar, 2020
Submission checks complete
On 09 Mar, 2020
Editor invited
On 09 Mar, 2020
No comments provided
Editorial decision: Major revision
On 07 Feb, 2020
Review #2 received
Received 02 Feb, 2020
Reviewer #2 agreed
On 16 Jan, 2020
Review #1 received
Received 07 Oct, 2019
Reviewers invited
Invitations sent on 26 Sep, 2019
Reviewer #1 agreed
On 26 Sep, 2019
Editor assigned
On 04 Sep, 2019
Submission checks complete
On 03 Sep, 2019
Editor invited
On 03 Sep, 2019
No comments provided
Editorial decision: Major revision
On 06 Aug, 2019
Review #2 received
Received 05 Aug, 2019
Review #1 received
Received 01 Aug, 2019
Reviewer #3 agreed
On 24 Jul, 2019
Reviewer #2 agreed
On 21 Jul, 2019
Editor assigned
On 19 Jul, 2019
Reviewers invited
Invitations sent on 19 Jul, 2019
Reviewer #1 agreed
On 19 Jul, 2019
Submission checks complete
On 16 Jul, 2019
Editor invited
On 16 Jul, 2019
First submitted
On 05 Jul, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Anesthesiology & Pain Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
The most recent version of this article is available here.
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 embodied in a novel algorithm that took into account patients’ vital signs (oxygen saturation, heart rate). The system aimed to allow responsive titration of personalized pain relief to optimize pain relief and reduce the risk of respiratory depression. Moreover, the system would 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 at least 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 median percentage time during treatment that oxygen saturation fell below 95% was 1.9%. 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 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 The use of VPIA analgesic infusion pump, when integrated with continuous vital sign monitor and variable lockout algorithm, was able to provide pain relief with good patient satisfaction.
Figure 1
Figure 2
Figure 3
Figure 4