TPT 1.10 Oral Analgesia: A Better Alternative to PCA for Pain Control after Major Minimally Invasive Colorectal Surgery

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ID: 323975
2026
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Abstract
Abstract Aims Patient-controlled analgesia (PCA) is commonly used to manage post-operative pain after major minimally invasive colorectal surgery (MICS). However, it can impede patient progression through the Enhanced Recovery Pathway (ERP) due to reduced mobility, adverse side effects and misuse risk. We aimed to assess the efficacy of oral analgesia (OA) as an alternative to PCA. Method Data for pain control after MICS was collected retrospectively for patients using PCA (morphine or oxycodone), between October 2024–March 2025 (N=82) and prospectively for patients using OA (immediate-release oxycodone for 24 hours with step-down to tramadol) between April 2025–September 2025 (N=49). Outcomes assessed included pain scores (0-10 numeric rating scale), post-operative day trial without catheter (TWOC), discharge from physiotherapy and length of stay (LOS). Results Cohorts were similarly matched for age, gender and type of resection. There was no significant difference in mean post-operative pain scores at 6 hours (PCA 1.17 ±2.31; OA 1.31 ±2.92), 12 hours (PCA 2.00 ±2.80; OA 1.00 ±3.12), 24 hours (PCA 3.94 ±3.03; OA 3.14 ±3.12), or 48 hours (PCA 2.56 ±2.98; OA 2.53 ±5.21). Median day of TWOC was earlier in the OA group (1 vs 2, p<0.05), as was discharge from physiotherapy (2 vs 3 days, p<0.05). LOS was significantly shorter in the OA group (median 4.5 vs 5.9 days, p<0.05). Cost per patient was £6.02 for OA compared to £16.03 for PCA. Conclusion OA provides similar efficacy in managing post-operative pain compared with PCA, progresses patients faster through ERP, reducing LOS and is cheaper.
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openalex_W7172541939 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Timothy Chau, Priyanga Kumarakulasingam, Elena Sava-Siong, Samreen Fathema, Venkatraman Hariharan, Anjana Singh
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.166
URL
https://doi.org/10.1093/bjs/znag087.166
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