Abstract
Two patients suffering from chronic intractable pain were treated with intravenous patient-controlled analgesia (PCA) with fentanyl. During the course of the PCA therapy, the pain was not relieved sufficiently when the patients had a relatively long infusion line for PCA which was connected to a continuous intravenous infusion line. Side effects associated with fentanyl, such as drowsiness, were also observed. We then connected the PCA system to the most proximal part of the continuous intravenous infusion line in order to obtain a rapid onset of fentanyl action with administration of a single bolus injection. This improved the pain relief and decreased the side effects. Hence, we believe that the length of the infusion line may be an important factor in determining the adequacy of pain control during PCA with fentanyl.
