Patient-controlled versus scheduled, nurse-administered analgesia following vaginal reconstructive surgery: a randomized trial

Objective To determine whether patient-controlled analgesia or scheduled intravenous analgesia provides superior pain relief and satisfaction with pain control after vaginal reconstructive surgery. Study Design Fifty-nine women scheduled for vaginal reconstructive surgery were enrolled in this rando...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2012-11, Vol.207 (5), p.433.e1-433.e6
Main Authors: Crisp, Catrina C., MD, Bandi, Sindura, MD, Kleeman, Steven D., MD, Oakley, Susan H., MD, Vaccaro, Christine M., DO, Estanol, Maria V., MD, Fellner, Angela N., PhD, Pauls, Rachel N., MD
Format: Article
Language:English
Subjects:
Aged
Analgesia - nursing
Analgesia, Patient-Controlled - methods
Analgesics, Opioid - administration & dosage
Biological and medical sciences
Female
Gynecologic Surgical Procedures - methods
Gynecology. Andrology. Obstetrics
Humans
Hydromorphone - administration & dosage
intravenous analgesia
Length of Stay
Medical sciences
Middle Aged
Obstetrics and Gynecology
pain control
Pain Measurement
Pain, Postoperative - drug therapy
Patient Satisfaction
patient-controlled analgesia (PCA)
postoperative analgesia
Postoperative Complications - chemically induced
Vagina - surgery
vaginal surgery
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Summary:Objective To determine whether patient-controlled analgesia or scheduled intravenous analgesia provides superior pain relief and satisfaction with pain control after vaginal reconstructive surgery. Study Design Fifty-nine women scheduled for vaginal reconstructive surgery were enrolled in this randomized trial. Operative procedures and postoperative orders were standardized. Visual analog scales for pain and satisfaction with pain control were recorded during the hospital stay and 2 weeks after surgery. Results Patients receiving patient-controlled analgesia had less pain on postoperative day 1, 25 mm vs 39 mm, on visual analog scales ( P = .007). Although this group used twice as much hydromorphone (3.57 mg vs 1.48 mg, P < .001), there was no difference in side effects, length of hospital stay, or complications. For the sample overall, larger amounts of narcotic used correlated with higher pain scores (r = 0.364, P = .009) and worse satisfaction scores (r = −0.348, P = .012). Conclusion In patients undergoing vaginal surgery, patient-controlled analgesia offers superior pain relief on postoperative day 1 when compared with scheduled, nurse-administered hydromorphone.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2012.06.040