Postoperative pain : patient controlled analgesia versus non-patient controlled analgesia

Abstract

Background: Up to 75% of patients experience pain post-operatively. Most of whom describe it as moderate to severe (Apfelbaum et al.,). Although pain should be expected, it can also hinder the recovery process, which is why it should be adequately addressed. Physical pain leads to emotional pain in the form of helplessness (Shanmugam, 2017) which causes further distress. All these factors delay healing and the return to a normal life, which is why pain management should be a priority. Research Question: In post-operative patients, does patient-controlled analgesia provide better pain relief when compared to non-patient-controlled analgesia? PICO Elements: The Population (P) studied were post-operative patients who experienced pain. The Intervention (I) was patient-controlled analgesia (PCA) in Comparison (C) with non-patient-controlled analgesia (non-PCA). The Outcome (O) being measured is pain relief. Method: A detailed and structured search, based on the inclusion and exclusion criteria, was conducted using different online databases. The articles chosen were all peer reviewed and published within the last decade. Five key studies were retrieved (One Systematic review (SR), 3 Randomised controlled trials (RCTs) and 1 Cohort study). Critical appraisal of these articles was carried out using the appropriate CASP tools to extrapolate all the relevant information which can be used in Evidence based practice (EBP). Results: A conclusive verdict about which analgesia method is superior could not be reached based off the 5 articles used alone. This is due to the different results obtained in each study. However, all 5 articles seem to emphasise the need for caution when choosing between PCA and non-PCA as it seems to benefit certain surgeries over others. Further research is required. Implications and Recommendations: Education regarding post-operative pain should be implemented among the appropriate departments. Frequent assessments of pain in post-operative patients should be carried out. Local research should be carried out for more accurate results to be used in EBP.