Patient Controlled Analgesia and its effect on postoperative outcomes in an older cohort of patients undergoing orthopaedic procedures: A retrospective observational study

Mayura Thilanka Iddagoda, Andrew Nienaber, Carina Pretorius, Leon Flicker

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Patient Controlled Analgesia is a popular technique used to manage postoperative pain. The suitability of Patient Controlled Analgesia in older patients after surgical procedures and its effect on postoperative outcomes are not clear. Method: The records of 305 older patients undergoing orthopaedic surgeries in a single tertiary centre were reviewed. Postoperative outcomes were compared between those given Patient Controlled Analgesia and those who were not, using multinomial logistic regression adjusted by propensity scores. Results: Physical function on day 3 after surgery is worse, and risk of requiring personal assistance is higher if the patient had Patient Controlled Analgesia (p = 0.01). Length of stay in patients using patient-controlled analgesia was longer than patients not using patient-controlled analgesia (p = 0.002), and patients given Patient Controlled Analgesia had higher odds of needing support on discharge (p = 0.01). Surprisingly, pain control is poor in the Patient Controlled Analgesia group (p = 0.009). Conclusion: In this review, Patient Controlled Analgesia use was common (40% of our sample), and postoperative outcomes such as physical function on day 3, length of stay and discharge destination were unfavourable in patients who had Patient Controlled Analgesia.

Original languageEnglish
Pages (from-to)190-196
Number of pages7
JournalJournal of Perioperative Practice
Volume33
Issue number6
Early online date5 Jul 2022
DOIs
Publication statusPublished - Jun 2023

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