Postoperative surgical site infections were increased for patients treated with patient-controlled analgesia (PCA) pumps after intestinal surgery, according to results of a retrospective chart review reported in the summer issue of Surgical Infections. However, this study could not establish a causal relationship, which awaits confirmation in prospective trials.
“PCA pumps are widely used after surgery, but their association with various outcomes is not completely understood,” write Susan D. Horn, PhD, from the Institute for Clinical Outcomes Research in Salt Lake City, Utah, and colleagues. “Is PCA pump use related to the incidence of postoperative surgical site infections among patients undergoing open intestinal surgery?” Of 515 randomly selected patients older than 18 years who had major rectal or intestinal surgery at one of eight community or teaching hospitals along the West Coast between January 1994 and March 1997, 214 patients used PCA pumps.
The rate of in-hospital postoperative surgical site infections was 10.7% for patients who used PCA and 4.0% for those who did not (P=.004). After controlling for many variables, PCA use quadrupled the risk of postoperative surgical site infection. “No confounding variables explained the significant association between PCA pump use and in-hospital surgical site infection,” the authors write. “These results stand firmly on data that merit additional study to further elucidate possible immunologic effects of PCA pumps.”
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