Background. Acute postoperative pain delays recovery and increases morbidity and mortality. Opioid therapy is effective but is accompanied by adverse reactions. Patient-controlled analgesia (PCA) enables self-administration of analgesics. Oral-PCA is a safe and beneficial alternative to intravenous (IV) PCA. We have developed a novel Oral-PCA device, which enables self-administration of solid pills to the patient’s mouth. This is a retrospective study comparing the effectiveness and usability of this novel Oral-PCA with those of IV-PCA. Methods. Medical records of patients who received PCA following gynecology and orthopedic surgeries were analyzed. The control cohort (n = 61) received oxycodone by IV-PCA. The test cohort (n = 44) received oxycodone by Oral-PCA via the PCoA Acute device. Outcome measures include the Numeric Rating Scale (NRS) score at rest and movement, side effects, technical difficulties, bolus dose administered, and bolus dose requested. Results. Patient demographics, initial NRS, and PCA duration were comparable between cohorts. NRS reduction in rest and movement was stronger in the Oral-PCA cohort (rest: 1.61 and 2.27,  = 0.077; movement: 2.05 and 2.84,  = 0.039), indicating better pain control and mobility for Oral-PCA. Side effect rates were comparable between cohorts (9% and 11% of patients who experienced side effects,  = 1.000). The rate of technological difficulties was higher in the Oral-PCoA cohort (19.7% and 36.4%,  = 0.056). The mean total bolus dose administered to patients was comparable in both cohorts (18.32 mg and 21.14 mg oxycodone,  = 0.270). However, the mean total boluses requested by patients during lockout intervals were lower in the Oral-PCA cohort (12.8 mg and 6.82 mg oxycodone,  = 0.004), indicating better pain control. Conclusions. Oral-PCA by using PCoA® Acute provides pain control and usability which is noninferior to the IV-PCA, as well as superior to pain reduction in rest and movement. These results, along with the noninvasiveness, medication flexibility, and reduced cost, suggest the potential of Oral-PCA, by using PCoA Acute, to replace IV-PCA for postoperative analgesia.

中文翻译：

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病人自控镇痛（PCA）：使用新型装置（PCoA®Acute）对急性术后住院患者进行静脉给药（IV-PCA）与口服给药（Oral-PCA）—一项比较性回顾性研究

背景。急性术后疼痛会延迟恢复，并增加发病率和死亡率。阿片类药物治疗有效，但伴有不良反应。病人自控镇痛（PCA）可实现镇痛药的自我管理。口服PCA是静脉（PC）PCA的安全和有益替代品。我们已经开发了一种新型的口服PCA设备，可以将固体药丸自动给药到患者的口腔。这是一项回顾性研究，比较了该新型口服PCA和IV-PCA的有效性和可用性。方法。分析了妇科和整形外科手术后接受PCA的患者的病历。对照组（n  = 61）通过IV-PCA接受羟考酮。测试队列（Ñ = 44）通过PCoA Acute设备通过口服PCA收到了羟考酮。结果指标包括休息和运动时的数字评分量表（NRS）得分，副作用，技术难度，所施的推注剂量和要求的推注剂量。结果。队列之间的患者人口统计学特征，初始NRS和PCA持续时间相当。口服PCA队列中NRS的休息和运动减少更明显（休息：1.61和2.27， = 0.077；运动：2.05和2.84， = 0.039），表明口服PCA的疼痛控制和活动性更好。队列之间的副作用发生率相当（发生副作用的患者中，分别为9％和11％， = 1.000）。口服PCoA队列的技术难题发生率更高（分别为19.7％和36.4％， = 0.056）。在两个队列中，给予患者的平均总推注剂量相当（18.32 mg和21.14 mg羟考酮， = 0.270）。但是，在口服PCA队列中，患者在停药间隔期间要求的平均总剂量较低（12.8 mg和6.82 mg羟考酮， = 0.004），表明疼痛控制效果更好。结论。通过使用PCoA®Acute进行的口服PCA提供的疼痛控制和可用性不亚于IV-PCA，并且在减少休息和运动中的疼痛方面更胜一筹。这些结果，以及无创性，药物灵活性和降低的成本，表明口服PCA通过使用PCoA Acute替代IV-PCA进行术后镇痛的潜力。