title: Patient-controlled versus scheduled, nurse-administered analgesia following vaginal reconstructive surgery: a randomized trial.
abstract: OBJECTIVE
  To determine whether patient-controlled analgesia or scheduled intravenous analgesia provides superior pain relief and satisfaction with pain control after vaginal reconstructive surgery.
  
  
  METHODS
  Fifty-nine women scheduled for vaginal reconstructive surgery were enrolled in this randomized trial. Operative procedures and postoperative orders were standardized. Visual analog scales for pain and satisfaction with pain control were recorded during the hospital stay and 2 weeks after surgery.
  
  
  RESULTS
  Patients receiving patient-controlled analgesia had less pain on postoperative day 1, 25 mm vs 39 mm, on visual analog scales (P = .007). Although this group used twice as much hydromorphone (3.57 mg vs 1.48 mg, P < .001), there was no difference in side effects, length of hospital stay, or complications. For the sample overall, larger amounts of narcotic used correlated with higher pain scores (r = 0.364, P = .009) and worse satisfaction scores (r = -0.348, P = .012).
  
  
  CONCLUSIONS
  In patients undergoing vaginal surgery, patient-controlled analgesia offers superior pain relief on postoperative day 1 when compared with scheduled, nurse-administered hydromorphone.
authors.affiliation: Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Good Samaritan Hospital, Cincinnati, OH 45220, USA. Catrina_Crisp@trihealth.com
authors.forename: Catrina C
authors.initials: CC
authors.lastname: Crisp
authors.forename: Sindura
authors.initials: S
authors.lastname: Bandi
authors.forename: Steven D
authors.initials: SD
authors.lastname: Kleeman
authors.forename: Susan H
authors.initials: SH
authors.lastname: Oakley
authors.forename: Christine M
authors.initials: CM
authors.lastname: Vaccaro
authors.forename: Maria V
authors.initials: MV
authors.lastname: Estanol
authors.forename: Angela N
authors.initials: AN
authors.lastname: Fellner
authors.forename: Rachel N
authors.initials: RN
authors.lastname: Pauls
mesh_terms: D000368:Aged; D000698:Analgesia / Q000451:nursing*; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D004091:Hydromorphone / Q000008:administration & dosage; D007902:Length of Stay; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000139:chemically induced; D014621:Vagina / Q000601:surgery*
chemical_list: D000701:Analgesics, Opioid; D004091:Hydromorphone