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.
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