Patient-controlled analgesia and length of hospital stay in orthognathic surgery: A randomized control trial

Publication date: Available online 11 October 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Frank Sheng-Chun Chang, Dieter Paul Gebauer, Sally Burrows

Abstract

Objectives

The objective of this prospective randomized controlled pilot study for patients undergoing orthognathic surgery was to compare the hospital length of stay (LOS) in patients using intravenous patient-controlled analgesia (PCA) to those patients on scheduled and as needed (pro re nata; prn) oral analgesia.

Study Design

Forty patients (19 male, 21 female) aged 15 to 56 (mean 20.73, SD 6.87) were recruited prospectively and randomised to PCA and non PCA groups of equal size. Patient self-recorded pain score using visual analogue scale (VAS) was commenced at 8:00 am on day one following surgery until discharge. The pain score during routine nursing observations from postoperative period was recorded until patient was discharged from hospital.

Results

Randomisation resulted in approximately equal proportions of males (45% vs 50%) and median age (18.5 vs 20) for PCA vs non-PCA groups however the PCA group was noted to have a higher proportion of double jaw surgeries (65% vs 40%). The median LOS was 2 days for both PCA and non-PCA group (p=0.06),. There was no statistically significant difference in pain scores between the two groups either at rest or on movement (p=0.27, p=0.13 respectively).

Conclusion

No evidence was found to indicate the superiority of either PCA or non-PCA regimes with respect to LOS and pain scores however this is not evidence of equivalence of the two pain management approaches.

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