Patient-controlled versus scheduled, nurse-administered analgesia following vaginal reconstructive surgery: a randomized trial

Objective To determine whether patient-controlled analgesia or scheduled intravenous analgesia provides superior pain relief and satisfaction with pain control after vaginal reconstructive surgery. Study Design 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 P = .009) and worse satisfaction scores (r = −0.348, P = .012). Conclusion In patients undergoing vaginal surgery, patient-controlled analgesia offers superior pain relief on postoperative day 1 when compared with scheduled, nurse-administered hydromorphone.