Structured preoperative patient education for patient-controlled analgesia

Abstract

Study objective: To investigate the effectiveness of a structured preoperative education program in patients receiving patient-controlled analgesia (PCA).

Design: Randomized controlled trial.

Setting: University-affiliated hospital.

Patients: 60 ASA physical status I and II women undergoing major gynecologic surgery.

Interventions: Patients were randomly allocated to receive either standard information given during routine preanesthetic assessment (n = 30) or additional structured preoperative education on the use of PCA (n = 30).

Measurements: All patients received standard anesthesia and PCA was provided for postoperative analgesia. Patients were reviewed bid by an independent team of pain specialists and nurses. Patient satisfaction, severity of postoperative pain, nausea, dizziness, and morphine consumption were measured at discharge from recovery room, 24, and 48 hours after operation. Recovery characteristics of patients were also measured.

Main results: Pain scores and morphine consumption decreased over time (p < 0.01), but there was no significant difference between groups. The overall analgesic efficacy, side effects, and recovery times was not affected by the education program. Patient satisfaction in the education group was better than control during early recovery (p= 0.03), but there was no additional benefit in the remaining postoperative period.

Conclusions: Structured preoperative PCA education did not affect patient outcome. The early improvement in patient satisfaction was minimized by continued education and pain team supervision during the rest of the postoperative period.