Science & Technology: Pain Control After Surgery Reduces Days of Hospitalization, According to University Study

Effective postoperative pain control using continuous peripheral nerve block reduces patients’ hospital stays by nearly a day on average, Pitt School of Medicine physicians reported during the 81st Clinical and Scientific Congress of the International Anesthesia Research Society on March 26.

Decreasing the time that patients spend in the hospital helps to reduce their exposure to the risk of hospital-acquired infection and associated complications, and also has an overall economic benefit, said Jacques E. Chelly, professor and vice chair of the Pitt medical school’s Department of Anesthesiology, who presented the study results.

“For many people, the prospect of having pain is more stressful than the surgery itself,” Chelly said “If they know that specialists in acute pain medicine can help to minimize the pain associated with surgery, these patients are less stressed and more willing to have the surgery they need.”

Chelly and his colleagues analyzed the hospitalization experiences of 1,527 patients, including 495 undergoing surgery between July 1, 2001, and Aug. 30, 2002, and 1,032 who underwent surgery following the institution of a formalized postoperative pain medicine program, called the acute interventional postoperative pain service, between
July 1, 2004, and Aug. 30, 2005. The study included patients who underwent total hip or total knee replacement, chest surgery, or prostate surgery.

“Prior to the implementation of our postoperative pain management program, the average length of hospital stay was about three to five days,” said Chelly, who also is director of orthopaedic anesthesia and the acute interventional postoperative pain service at UPMC Shadyside Hospital. “The use of the acute interventional postoperative pain service allowed patients to recover faster, and they were discharged from the hospital an average of 0.675 days per patient earlier, for a total of 597.7 days of hospitalization saved a year.”

Before the introduction of the acute interventional postoperative pain service, postoperative pain was managed by surgeons and mostly limited, according to Chelly. “Morphine and patient-controlled analgesia were used,” he said. “Now, we can do a peripheral nerve block and use other medications, making postoperative pain control more effective.”