Penington, P., Caminniti, S., Schein, J.R., Hewitt,

¶ … Penington, P., Caminniti, S., Schein, J.R., Hewitt, D.J., & Nelson, W.W. (2009). Patients' Assessment of the Convenience of Fentanyl HCl Iontophoretic Transdermal System (ITS) Versus Morphine Intravenous Patient- Controlled Analgesia (IV PCA) in the Management of Postoperative Pain After Major Surgery, Pain Management Nursing, 10, 124-133

to evaluate patients' assessment of fentanyl ITS and morphine intravenous patient-controlled analgesia (IV PCA)

Research question/objective/hypothesis

Two previous studies used Ease of Care questionnaire in order to assess the superiority of ITS over morphine intravenous patient-controlled analgesia. However extensive analysis of the EOC data was not collected. This study intends to do just that, assessing the convenience of each patient modality using the EOC questionnaire form both previous studies.

Review of the literature

There is inadequate management of postoperative pain, which can impact a host of conditions including chronic pain. Patient controlled anesthesia is preferred to clinician-controlled anesthesia. The common analgesic used until now is PCA morphine, but this has its limitation. A recent PCA that has just been approved for acute post operative pain management is patient-controlled fentanyl HCl iontophoretic transdermal system ITS) (fentanyl ITS; IONSYS™; Ortho-McNeil, Raritan, NJ). Two studies (one on patients with total hip replacement surgery (THR); and the other conducted on patients undergoing abdominal or pelvic surgery (APS)), using Ease of care questionnaire have been conducted on comparison of the modalities and results have seemed to indicate superior EOC for ITS.

5. Conceptual/theoretical framework

Two studies (one on each patient group) that were studies were open-label,

randomized, multicenter, active-controlled phase using questionnaires (Likert scale) that were statistically analyzed.

6 Variables or key concepts studied

Variables of Ease of care of ITS as compared to variables of EOC involved with

7. Significance of the problem to nursing

To assess whether OTS can be used as postoperative pain management system and whether its use in all variables is better to that of current modalities.

8. Design and method

Two studies, similar in design, one on patients with total hip replacement surgery (THR), the other conducted on patients undergoing abdominal or pelvic surgery (APS), using EOC questionnaires (Likert scale) and then statistically analyzed.

9. Subjects (participants)

(a) patients with total hip replacement surgery (THR), (b) patients undergoing abdominal or pelvic surgery (APS). All were 18 years or older and expected to receive parenteral opioids for 24 hours and above after their surgery.

10. Instruments used

The Ease of Care questionnaire scored on a 6-point Liker scale

11. Data analysis methods

Statistical analysis with, depending on the nature of the variable, either an ANOVA with treatment as the factor or an uncorrected chi-square (categorical data).

12. Findings and Limitations