Constipation after total hip replacement may be lower with oral opioid analgesia than with intravenous opioid analgesia

Rothwell, Matt; Pearson, David; Hunter, J. D.; Mitchell, Philip; Graham-Woollard, T.; Goodwin, Lynsey; Dunn, G. L.

doi:10.1093/bja/aes010

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…[15][16][17] Patient-controlled oral analgesia (PCOA) is a novel method of oral opioid administration practiced at our institution whereby breakthrough pain is managed with a set dose of a short-acting oral opioid that is available at the patient's bedside and is replaced if exhausted following regular lockout intervals (every two hours) while patients record pain levels and opioid use. 18 Patient-controlled oral analgesia may offer benefits such as a better analgesic profile, increased mobility, and less constipation, 19 and allows patients to vary their analgesia more easily according to pain and activity levels, 20 while minimizing costs. Evidence for PCOA is limited but supportive; the concept was first introduced in case studies.…”

Section: Re ´Sumementioning

confidence: 99%

Factors associated with success and failure of patient-controlled oral analgesia after total hip and knee arthroplasty: a historical comparative cohort study

Vorobeichik

Hoydonckx

Kumar

et al. 2020

Can J Anesth/J Can Anesth

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Purpose Patient-controlled oral analgesia (PCOA) is a novel method of oral opioid administration using set doses of short-acting oral opioids self-administered by patients with a ''lockout'' period as part of a multimodal regimen. Failure of PCOA can result in severe postoperative pain necessitating use of intravenous patient-controlled analgesia (IV-PCA) with its potential complications. This study evaluated factors related to success or failure of PCOA following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Methods We conducted a retrospective cohort study of all adults who underwent THA and TKA at our institution by extracting data from the proprietary database of our acute pain service. Patient, anesthetic, and surgical variables associated with PCOA failure defined as inadequate analgesia requiring conversion to IV-PCA within 24 hr following THA and TKA were evaluated. Univariable and multivariable logistic regression analyses were performed to identify predictors of PCOA failure.

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