ArticleActa anaesthesiologica Scandinavica2026
The Influence of Profession, Experience and Geographical Region on Intra- and Postoperative Opioid Practice in Denmark: A Post Hoc Analysis of the OPIAID Survey.
Article in Acta anaesthesiologica Scandinavica, 2026. 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
backgroundClinicians often administer opioids to manage postoperative pain, but with considerable variation in chosen opioid and dosing strategies. This post hoc analysis of a Danish nationwide survey assessed how profession, length of experience, and geographical region impact dosing in the intraoperative phase (end of surgery) and the postoperative phase (PACU) for postoperative control.
methodsA 37-item online survey on opioid practice amongst anaesthesia personnel in Denmark (5 February-30 April 2024). Regression analyses compared intravenous morphine equivalent doses (MEQ) in eight clinical cases for three provider characteristics: profession (physician/nurse), length of experience (> < 10 years) and geographical region (five regions). We predefined differences ≥ 0.03 mg/kg MEQ as clinically relevant. We qualitatively described group differences in perioperative factors guiding dose adjustments, defining differences ≥ 10% as relevant.
resultsThe overall response rate was 48% (2025/4187). In four intraoperative clinical cases, anaesthesiologists administered on average 0.04 mg/kg MEQ less than nurse anaesthetists (95% CI: 0.03 to 0.04, p < 0.001), considered clinically relevant. Respondents with short working experience (< 10 years) administered 0.01 mg/kg MEQ less (95% CI: 0.00 to 0.02, p = 0.001). Respondents in the North Denmark Region administered 0.07 mg/kg MEQ more than the national average of 0.32 mg/kg MEQ (p < 0.001), considered clinically relevant. In postoperative clinical cases, significant dosing differences between short versus long working experience were not considered clinically relevant. Clinically relevant differences in dose-adjusting factors existed between professions (preoperative opioid use, age, body weight, alcohol use, chronic pain, and ASA classification) and regions (chronic pain, body weight, preoperative opioid use, ASA classification, sedation, BMI, and nausea).
conclusionClinical profession and regional background contribute to variation in opioid dosing strategies. Nurse anaesthetists and respondents from the North Denmark Region administered significantly and clinically relevant higher doses of opioids. Clinically relevant differences existed between professions and regions regarding opioid dose-adjusting factors. EDITORIAL COMMENT: This secondary analysis of survey results from Denmark regarding opioid choices and dosing preferences for post-surgical analgesia focused on professional categories and regions within Denmark. Some apparent dosing preference differences were described between professional groups and also between regions.
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