Little information exists to compare traditional oral or rectal delivery routes of analgesics for acute postoperative pain treatment in outpatients with the more pharmacokinetically flexible technique of patient controlled analgesia (PCA). Beyond PCA's impact on pain intensity per se, almost nothing is known regarding its postoperative use in ambulatory patients in relation to side effects, patient satisfaction, or functinal capacity. In light of the increasing pressures for same day discharge after surgery of progressively greater invasiveness, it is important to explore the application of more effective means of analgesia as a means to achieve early discharge. We therefore propose to undertake a prospective, randomized controlled trial comparing safety, efficacy, and patient satisfaction during PCA vs. conventional (oral ) analgesia. The null hypothesis to be tested is that the two modalities provide equivalent safety and efficacy in ambulatory outpatients following same-day surgery.
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