PCA (Patient Controlled Analgesia) by Fentanyl citrate is used as a method of pain control after orthopaedic surgery and NSAIDs is prescribed after PCA at Hiroshima City Asa Hospital. There are many cases in which the effect by NSAIDs is insufficient, even if the analgetic effect by PCA is sufficient. In addition, the use of Opioid's adaptation is limited, because it is designated as a narcotic in Japan. Thus we examined the analgetic effect, for the purpose of early rehabilitation, by relieving the pain that patients experience when moving their bodies by using Codeine phosphate tablets which are both effective and can be orally administered.
Codeine phosphate 20mg tablets were administered at a dosage of 80mg just after PCA and thereafter 60mg every 4 hours until bedtime. Patients were next administered 80mg when they got up in the morning and 40mg of each every 3 hours until bedtime from the 2 nd day after the operation. We classified the analgetic effect of Codeine phosphate into 5 grades by using a face scale pain score.
Codeine phosphate had no effect on the pain when the patients lay quietly in bed. However the pain score significantly decreased to less than 3 (painful) after operation after the administration of Codeine phosphate when they moved their bodies. The pain score on males decreased significantly in comparison with females. Accordingly, it seems that the administration of Codeine phosphate is an effective means to reduce pain when patients move their bodies after operations in the field of orthopaedic surgery.
