Abstract
Objective:
This randomized controlled trial (RCT) aims to evaluate and compare the efficacy, safety, and patient satisfaction between oral and intravenous (IV) analgesic delivery methods for managing acute postoperative pain in patients undergoing major surgical procedures at a tertiary hospital in Peshawar, Khyber Pakhtunkhwa (KP), Pakistan.
Methods:
Between January and December 2024, a total of 300 adult patients were randomly assigned to two groups: one receiving oral analgesia (Group O) and the other receiving intravenous analgesia (Group V). The study primarily measured pain intensity at five predefined time points (2, 6, 12, 24, and 48 hours post-surgery) using the Visual Analogue Scale (VAS). Secondary outcomes included opioid consumption, time to first rescue dose, adverse effects of analgesics, and patient satisfaction. Both groups received a combination of nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids, with adjustments based on surgical procedure and clinical needs.
Study Type: RCT
Results:
Initial findings showed that Group V (IV analgesia) had significantly lower pain scores in the first 6 hours post-surgery compared to Group O (oral analgesia), with mean VAS scores of 32.5 (± 11.3) versus 45.3 (± 12.6), respectively (p < 0.01). However, by 48 hours, both groups reported comparable pain scores (VAS: 37.4 ± 9.3 for Group V vs. 37.8 ± 10.5 for Group O). IV analgesia was associated with lower opioid consumption and quicker pain relief, but also a higher incidence of nausea and vomiting. Oral analgesia, on the other hand, resulted in fewer gastrointestinal side effects and similar patient satisfaction scores over the longer term.
Conclusion:
While intravenous analgesia provided more immediate pain relief, oral analgesia proved effective for managing pain in the later postoperative stages, offering a more cost-effective and side-effect-friendly alternative. This study supports the adoption of multimodal analgesic strategies, tailored to patient needs, to improve postoperative pain management.