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Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionBackground and Aims Fentanyl patient-controlled analgesia (PCA) has become the analgesic treatment of choice in the acute setting postoperatively in the Mercy University Hospital, Cork. This study will compare the pain profiles of patients who have underwent laparoscopic cholecystectomies (LC) and open cholecystectomies (OL) by examining trends of fentanyl PCA use. We will be aiming to recognise potential improvements in the delivery of pain medicine in the acute setting postoperatively.Methods This is a single centre, retrospective cohort study aiming to examine the use of fentanyl PCA since its introduction. The two groups of comparison in this study are those who underwent LCs and OCs. Quantities of fentanyl PCA used on day one postoperatively, it’s use throughout stay and time to discharge will help to understand the need for fentanyl PCAs in the acute care setting.Results Patients who underwent LCs were seen to use more fentanyl on average in the first 24 hours with 864 mcg in comparison to 676.92 mcg in OCs, possibly due to pneumoperitoneum. However, after the initial 24 hours postoperatively, the mean use of fentanyl in OCs and length of treatment far surpassed that of LCs, 2.58 days in comparison to 1.9 days respectively. 86.1% of patients received multimodal analgesia, with intravenous paracetamol (n=62) being administered to all of these patients. 83.3% of patients were well enough to undergo physiotherapy to improve postoperative recovery outcomes.Abstract P225 Figure 1Comparison of the total use of fentanyl on day 1 postoperativelyAbstract P225 Figure 2Comparison of the total use of fentanyl postoperativelyConclusions The use of fentanyl PCAs allowed adequate pain relief for a large portion of patients to mobilise early, undergo physiotherapy and thus improve recovery quality and shorten hospital stays. This study showed that changes to local prescribing protocols are required in both open and laparoscopic analgesics in order to optimise pain relief and improve recovery. Future research should consider comparing fentanyl PCAs to PCAs with other analgesics employed, with emphasis on multimodal analgesia.