In this study, we evaluated the effect of postoperative pain relief witha PCA (patient controlled analgesia) pump system in patients with head and neck cancer. Fifteen patients underwent surgery for head and neck cancer and were subsequently given analgesia via continuous intravenous infusion of morphine (0.5 to 1.2mg/hr, for 48 hours). Pain was assessed by means of a visual analogue scale (VAS), pain score, and sedation score at 12, 24, 36, and 48 hours after surgery. The occurrence of side effects was studied. Pain intensity evaluated according to the VAS was under 5 cm or less in all 15 patients and 2 cm or less in 7 patients (46.7%) 12 hours after surgery. Forty-eight hours after surgery, 8 of the 15 patients were pain free. The use of other analgesics such as opioid analgesics, nonsteroidal anti-inflammatory drugs, or both was lower in the PCA pump system group than in patients who did notuse a PCA pump system. Deep sedative status did not develop in any of the 15 patients. Suppression of enterokinesis occurred in some patients, but responded to glycerol enema, and adynamic ileus did not develop. Continuous infusion of morphine with a PCA pump can be highly effective and safe for the control of postsurgical pain in the head and neck region.
