ArticleJournal of anesthesia2025
Incidences and predictors of moderate-to-severe movement-evoked pain until postoperative day three following gastrointestinal and hepatobiliary surgery: a retrospective study.
Article in Journal of anesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeWe investigated the incidence and predictors of moderate-to-severe movement-evoked pain (MEP) following gastrointestinal and hepatobiliary surgery and compare the findings for postoperative day one (POD1; Study A) and those for postoperative day three (POD3; Study B).
methodsWe retrospectively enrolled 1698 adult patients who underwent gastrointestinal or hepatobiliary surgery under general anesthesia. Postoperative MEP and resting pain were evaluated using an 11-point numerical rating scale (NRS), with moderate-to-severe pain defined as a score of ≥ 4. Information on perioperative variables was obtained from medical records, and binary logistic regression was performed to identify possible predictors.
resultsOn POD1, 54.4% (867/1595) of the patients reported moderate-to-severe MEP (Study A). Among those with moderate-to-severe MEP on either POD1 or postoperative day two, 63.1% (311/493) continued to experience moderate-to-severe MEP on POD3 (Study B). Risk factors of moderate-to-severe MEP on POD1 included young age (OR: 1.33, 95% CI 1.08-1.64), male gender (OR: 1.47, 95% CI 1.20-1.81) and preoperative pain (OR: 1.47, 95% CI 1.16-1.88), while epidural analgesia (OR: 0.61, 95% CI 0.50-0.75) was protective. Until POD3, overweight (OR: 1.65, 95% CI 1.03-2.65) and larger incision size (OR: 1.62, 95% CI 1.07-2.45) were identified as risk factors, while postoperative acetaminophen (APAP) alone (OR: 0.33, 95% CI 0.12-0.91) and APAP combined with non-steroidal anti-inflammatory drugs (OR: 0.26, 95% CI 0.09-0.71) were protective.
conclusionMore than a half of the patients with moderate-to-severe MEP on POD1 or POD2 continued to experience it on POD3. Distinct predictors for moderate-to-severe MEP on POD1 and POD3 were identified.
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