Introduction: Acute and severe pain is frequent in patients who undergo heart surgery and patient controlled analgesia (PCA) can be used to manage postoperative pain. Objective: To compare analgesia using PCA without continous infusion with PCA plus a continuous infusion of morphine on postoperative period of heart surgery and to assess pain scores, morphine consumption, number of demand, patient satisfaction and side effects. Methods: Randomized clinical trial was performed to assess patients who had undergone heart surgery who received either PCA with and without intravenous infusion of morphine. In the postoperative period, PCA was started at extubation in both regiments according to randomization. Pain intensity, morphine consumption, number of demand, satisfaction and side effects were assessed at zero, six, twelve, eighteen, twenty four and thirty hours after patients’ extubation. Results: The study enrolled 100 patients. 50 patients received PCA without continuous infusion of morphine (Group A), and 50 patients received morphine PCA plus a continuous infusion of morphine (Group B). Group B patients had less demand of morphine, consumed more morphine and were more satisfied regarding analgesia. No statistical differences were found between groups related to pain intensity, and side effects. Conclusions: Pain control was effective and similar in both groups. The same efficacy of analgesia and the less morphine consumption suggest that PCA without continuous infusion of morphine seems to be better option for postoperative pain manage in heart surgery. Descriptors: Analgesia, Patient-Controlled. Cardiovascular surgical procedures. Postoperative care. Resumo Introdução: A dor aguda e intensa faz parte do cotidiano dos pacientes que realizam cirurgia cardíaca, e para o controle da dor, pode-se dispor da analgesia controlada pelo paciente (PCA Patient controlled analgesia). Objetivo: Comparar a analgesia utilizando PCA sem infusão contínua com PCA mais infusão contínua de morfina no pós-operatório de cirurgia cardíaca e avaliar a intensidade dolorosa, consumo analgésico, número de solicitações analgésicas, satisfação e efeitos colaterais. Métodos: Ensaio clínico randomizado em que foram estudados pacientes submetidos a cirurgias cardíacas, que Correspondence address: Adriano Milanez. Instituto do Coração, Unidade de Coronariopatias Cirúrgicas. Av. Dr. Enéas de Carvalho Aguiar, 44, 2o andar, bloco II;– São Paulo, SP, Brasil – CEP 05403-000 E-mail: drmilanez@yahoo.com.br Article received on July 15th, 2009 Article accepted on January 7th, 2010
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