Factors associated with success and failure of patient-controlled oral analgesia after total hip and knee arthroplasty:
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REPORTS OF ORIGINAL INVESTIGATIONS
Factors associated with success and failure of patient-controlled oral analgesia after total hip and knee arthroplasty: a historical comparative cohort study Facteurs associe´s a` la re´ussite ou a` l’e´chec de l’analge´sie orale controˆle´e par le patient apre`s une arthroplastie totale de la hanche ou du genou : une e´tude de cohorte historique comparative Leon Vorobeichik, MD, FRCPC . Yasmine Hoydonckx, MD, FIPP . Pranab Kumar, MD, FRCPC, FRCA, FFPMRCA . Arlene Buzon-Tan, RN(EC) . Susan Walker, RN(EC) . Kyle Kirkham, MD, FRCPC . Dharini Ilangomaran, BSc . Lashmi Venkatraghavan, MD, FRCPC, FRCA . Atul J. Prabhu, MD, FRCA, FRCPC . Anuj Bhatia, MD, FRCPC, FRCA, FFPMRCA Received: 12 January 2020 / Revised: 25 August 2020 / Accepted: 31 August 2020 Ó Canadian Anesthesiologists’ Society 2020
Abstract 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 Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12630-020-01864-5) contains supplementary material, which is available to authorized users. L. Vorobeichik, MD, FRCPC Department of Anesthesia and Pain Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada Y. Hoydonckx, MD, FIPP P. Kumar, MD, FRCPC, FRCA, FFPMRCA K. Kirkham, MD, FRCPC L. Venkatraghavan, MD, FRCPC, FRCA A. J. Prabhu, MD, FRCA, FRCPC Department of Anesthesia and Pain Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada Department of Anesthesia and Pain Management, Toronto Western Hospital - University Health Network, Toronto, ON, Canada
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.
A. Bhatia, MD, FRCPC, FRCA, FFPMRCA (&) Department of Anesthesia and Pain Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada e-mail: [email protected] Department of Anesthesia and Pain Management, Toronto Western Hospital - University Health Network, Toronto, ON, Canada Toronto Western Hospital, McL 2-405, Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada
A. Buzon-Tan, RN(EC)
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