title: Is multimodal analgesia as effective as postoperative patient-controlled analgesia following upper extremity surgery?
abstract: BACKGROUND
  The present prospective study compared the clinical outcomes between a multimodal analgesia group and a patient-controlled analgesia (PCA) group for postoperative pain control in upper extremities surgery.
  
  
  OBJECTIVE
  Multimodal analgesia including pre-emptive analgesic can provide similar or superior analgesic effects and a lower incidence of adverse reactions than PCA following upper extremity surgery.
  
  
  METHODS
  Sixty-one patients undergoing upper extremity surgery were randomized to 2 perioperative analgesic groups (multimodal analgesia and PCA). We compared the clinical outcomes: use of additional pain rescue, opioid-related complication rate, and patient's satisfaction between the 2 groups.
  
  
  RESULTS
  No significant differences on the resting and exercise pain scores between the two groups. Also, there were no differences regarding additional pain rescue during postoperative day (POD) 1, 2 and achievement of rehabilitation protocol in both groups. However, use of additional pain rescue in PCA group was increased significantly after PCA removal. Moreover, there was significant difference in the incidence of opioid-related complications on operation day and at POD 1. At discharge, multimodal analgesia group showed significantly greater satisfaction than PCA group.
  
  
  CONCLUSIONS
  Perioperative pain management following upper extremity surgery through the multimodal analgesia could be an acceptable alternative method that can provide good results.
authors.affiliation: Department of Orthopedic Surgery, Eulji University College of Medicine, 1306 Dunsan-dong, Seo-gu, Daejeon 302-799, Republic of Korea. Electronic address: sklee@eulji.ac.kr.
authors.forename: S K
authors.initials: SK
authors.lastname: Lee
authors.forename: J W
authors.initials: JW
authors.lastname: Lee
authors.forename: W S
authors.initials: WS
authors.lastname: Choy
mesh_terms: D000328:Adult; D000368:Aged; D000698:Analgesia / Q000379:methods*; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery; D005081:Exercise Therapy; D005260:Female; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D010003:Osteoarthritis / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D059035:Perioperative Period; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016896:Treatment Outcome; D055815:Young Adult; D000092464:Elbow Injuries
chemical_list: D000701:Analgesics, Opioid
keywords: Multimodal perioperative analgesia; Patient-controlled analgesia; Postoperative pain