THE STUDY OF CLINICAL EFFECTIVENESS FOR PATIENT-CONTROLLED ANALGESIA SERVICES

• Main Authors: Hung-Chun Chen, 陳泓君
• Other Authors: Chia-Tai Chan
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/23066040032514325755

碩士 === 國立陽明大學 === 醫學工程研究所 === 98 === The self-regulated patient controlled analgesia (PCA) has become an established procedure for postoperative pain management through the electric-mechanical pumping control to deliver a bolus dose and a background infusion. Since the pain is subjective sense and pain measurement relies on the verbal report of patients, it is difficult to quantify and evaluate the clinical effectiveness of PCA therapy. The PCA logs that stored the drug delivery settings, patients’ demand/delivery condition, and therapeutic history were often neglected by most hospitals due to the shortage of manpower. Therefore, a rule-based evaluation of clinical effectiveness for miscellaneous PCA protocols using a novel index based on Fuzzy logic model is proposed to evaluate PCA pain care quality. In this study, we proposed a PCA therapy evaluation system that includes PCA D/D ratio generator and fuzzy control system. PCA D/D ratio generator intends to explore the relationship between patients’ demand and analgesic delivery (termed D/D ratio) during the therapy. Through a rule-based fuzzy control system, a referable PCA clinical effectiveness index that reveals therapeutic effectiveness of PCA therapy will be provided to the anesthesiologists to realize the patient’s pain relief profile and recovery status. A PCA effectiveness index (PCA EI) will be generated to grade the PCA therapeutic satisfaction into 5 levels. The PCA EI can faithfully reflect the analgesic satisfaction, offer doctors important treatment reference, and improve the PCA therapeutic quality.