Post-cardiac surgery anesthesia: comparison of patient-controlled regimens
I read the recent publication on anesthesia after cardiac surgery with a great interest . Mota et al.  concluded that "Pain control was effective and similar in both groups" and "Morphine PCA alone seems to be better for postoperative pain management in cardiac surgery, due to its less morphine expense with the same effectiveness." I agree that this is a good experimental study. However, there are some remained questions. The first question is on the exact unit cost for each approach. This should be clarified. In addition, comparative cost effectiveness should also be demonstrated. Second, whether there are any confounding factors due to basic pain perception, pre-operative cardiac pathology status and perioperative status of each patient is a question to be answered.
Viroj Wiwanitkit - Professor of Tropical Medicine, Visiting Professor, Hainan Medical College; Director, Editorial Office - Bangcoc/Thailand
1. Mota FA, Marcolan JF, Pereira MHC, Milanez AMM, Dallan LAO, Diccini S. Comparison study of two different patient-controlled anesthesia regiments after cardiac surgery. Rev Bras Cir Cardiovasc. 2010;25(1):38-44. [MedLine]