Pharmacist Educational Intervention in Intravenous Patient-Controlled Analgesia is Associated with Decreased Postoperative Pain
Background: Perioperative pain management reduces patient suffering throughout the surgery process. Patient-controlled analgesia has become a common technique for postoperative pain management, although in some cases, a patient’s lack of understanding of the treatment results in a decrease of its efficacy. Therefore, we examined the effects of a pharmacist intervention in acute pain control. Methods: In this study, patients who underwent artificial joint replacement at our orthopedics department between January 2013 and March 2014 were enrolled on a continuous basis. Seventy patients were eligible. The intervention comprised pre- and postoperative instruction on intravenous patient-controlled analgesia (IV-PCA) and ensured patients’ understanding of the rescue dose administration procedure. We retrospectively investigated whether a pharmacist intervention improved the Numeric Rating Scale (NRS) pain scores and the length of hospital stays. Results: The mean NRS score on postoperative day 1 was 3.8 ± 2.4 in the non-pharmacist intervention group and 2.3 ± 1.8 in the pharmacist intervention group, indicating a statistically significant difference between groups (p<0.01). The average length of hospital stays was 22.6 ± 6.2 days and 22.3 ± 6.0 days in the non-pharmacist intervention group and the pharmacist intervention group, respectively; however, this was not a statistically significant difference (p=0.44). Conclusion: Interventional education provided by pharmacists during the perioperative acute pain control phase improved patient understanding of IV-PCA usage and reduced NRS scores during the most painful postoperative period.
Ikkou Hirata*, Masateru Ito, Eri Hoshino, Masanori Suzuki, Mariko Kawana, Hirokazu Ishizuka, Junko Nagai, Hiromi Yoshinuma, Ryuichi Sekine, Ryohkan Funakoshi