How effective is patient-controlled analgesia? A randomized comparison of two protocols for pain relief during oocyte recovery

Although the conventional method of pain relief during outpatient oocyterecovery involves physician-administered drugs, patient- controlledanalgesia (PCA) offers an alternative technique with the potential to givewomen more control over peroperative analgesia. We conducted a prospectiverandomized study to compare the effect of fentanyl administered eitherthrough a PCA delivery system or by a physician. Thirty-nine women wererandomized to PCA during egg collection while 42 were allocated to receiveintermittent doses administered by a physician. Pain was evaluated by meansof a 100 mm linear analogue scale. The mean (SD) pain score in the PCAgroup was 38.5 (19.8) while in the other group it was 46.1 (21.3) (P =0.1). In the PCA group, 64% of women felt very satisfied with theiranalgesia as compared with 57% in the non-PCA group (P = 0.6). Among thePCA users, 39% of demands were successful. Significantly more fentanyl(97.5 microg) was used in the PCA group than in the other group (84.6microg) (P = 0.03). Though intraoperative PCA with fentanyl is an effectivealternative to physician-administered techniques, many women still feel theneed for more analgesia during the procedure.