Patient-Controlled Analgesia and Length of Hospital Stay in Orthognathic Surgery: A Randomized Controlled Trial

Abstract

The objective of this prospective, randomized controlled pilot study of patients undergoing orthognathic surgery was to compare the hospital length of stay (LOS) in patients using intravenous patient-controlled analgesia (PCA) versus patients receiving scheduled and as-needed oral analgesia. A total of 40 patients (19 male and 21 female patients) aged 16 to 56years (mean, 20.73years; standard deviation, 6.87years) were recruited prospectively and randomized to PCA and non-PCA groups of equal size.Recording of the patient-reported pain score using a visual analog scale was commenced at 8:00 am on day 1 after surgery until discharge. The pain score from routine nursing observations during the postoperative period was recorded until the patient was discharged from the hospital. Randomization resulted in approximately equal proportions of male patients (45% vs 50%) and median ages (18.5years vs 20years) for the PCA group versus the non-PCA group; however, the PCA group was noted to have a higher proportion of double-jaw surgery (65% vs 40%). The median LOS was 2days for both the PCA and non-PCA groups (P=.06). No statistically significant difference in pain scores was found between the 2 groups either at rest (P=.27) or on movement (P=.13). No evidence was found to indicate the superiority of either the PCA or non-PCA regimenwith respect to LOS and pain scores; however, this is not evidence of equivalence of the 2 pain management approaches.