Clinical study PEPCA : The effect of standardized preoperative patient education for patient-controlled regional analgesia on postoperative pain

Abstract

Patient-controlled analgesia (PCA) is awell-established form of postoperative pain management. One form of administration is patient-controlled regional analgesia (PCRA), where local anesthetics are administered via peripheral regional catheters; however, a prerequisite is that the patients are instructed on its use. Amultitude of sources recommend that these instructions are given before surgery as preoperative training on pain management procedures has been shown to significantly reduce patients' postoperative pain and increase their well-being. The aim was to assess the effect of guideline-assisted preoperative patient education for PCRA on postoperative pain in patients undergoing orthopedic surgery compared to unstructured postoperative standard instructions. Acontrolled study with two randomized samples and apostinterventional survey was conducted. Overall, 73patients with PCRA catheters for orthopedic surgery were enrolled in the study. The 37participants in the interventional group (IG) received guideline-based structured instructions on PCRA use as well as ahandout immediately before the surgical intervention. The 36patients in the control group (CG) received postoperative instructions in the anesthesia recovery room. Pain was documented according to the numerical rating scale (NRS) at 2h (t1), 6h (t2), and 24h (t3) after surgery. There were no statistically significant differences in the average pain scores between the two groups; however, there were lower mean pain scores in the IG at t1 and t3. Asignificant reduction of pain in the IG could not be shown. Further studies concerning this topic with larger samples and adapted points in time are recommended.