Randomized trial comparing 3 methods of postoperative analgesia in gynecology patients: patient-controlled intravenous, scheduled intravenous, and scheduled subcutaneous.
Author(s): Bell JG, Shaffer LE, Schrickel-Feller T
Affiliation(s): Department of Obstetrics and Gynecology, Riverside Methodist Hospital, Columbus, OH, USA.
Publication date & source: 2007-11, Am J Obstet Gynecol., 197(5):472.e1-7.
Publication type: Comparative Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
OBJECTIVE: The objective of the study was to determine whether any of 3 routes of opioid administration (patient-controlled analgesia [PCA], scheduled intermittent intravenous [i.v.], or scheduled intermittent subcutaneous [s.q.]) provides superior pain relief and satisfaction among patients undergoing abdominal gynecologic surgery. STUDY DESIGN: Patients were randomized to intravenous hydromorphone by PCA, i.v. hydromorphone via scheduled nurse-administered doses, or s.q. hydromorphone via scheduled nurse-administered doses. Self-reported pain and satisfaction were recorded over 48 hours following arrival at the nursing unit. Linear mixed effects modeling was used to compare outcomes among the groups. RESULTS: Neither pain scores nor satisfaction differed by group. PCA patients had higher total opioid use (P < .0001) and a higher rate of pruritus (P = .04). CONCLUSION: Given these findings as well as those in previous literature, no specific method of postoperative analgesia appears to be superior.