Patient Controlled Analgesia and its effect on postoperative outcomes in an older cohort of patients undergoing orthopaedic procedures: A retrospective observational study.
Orthopaedic surgery
Outcomes
Patient safety
Post anaesthetic care
Trauma
Journal
Journal of perioperative practice
ISSN: 2515-7949
Titre abrégé: J Perioper Pract
Pays: England
ID NLM: 101271023
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
medline:
5
6
2023
pubmed:
6
7
2022
entrez:
5
7
2022
Statut:
ppublish
Résumé
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. 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. 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). 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.
Sections du résumé
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.
Identifiants
pubmed: 35787709
doi: 10.1177/17504589221101437
doi:
Types de publication
Review
Journal Article
Langues
eng