Influential factors of postoperative pain trajectories in patients receiving intravenous patient-controlled analgesia: a single-centre cohort study in Taiwan

Objectives We aimed to investigate the factors associated with variations in postoperative pain trajectories over time in patients using intravenous patient-controlled analgesia (IV-PCA) for postoperative pain.Design Retrospective cohort study.Setting A single medical centre in Taiwan.Participants P...

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Main Authors: Hsiang-Ling Wu, Ying-Hsuan Tai, Mei-Yung Tsou, Kuang-Yi Chang, Shih-Pin Lin
Format: Article
Language:English
Published: BMJ Publishing Group 2019-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/11/e031936.full
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author Hsiang-Ling Wu
Ying-Hsuan Tai
Mei-Yung Tsou
Kuang-Yi Chang
Shih-Pin Lin
author_facet Hsiang-Ling Wu
Ying-Hsuan Tai
Mei-Yung Tsou
Kuang-Yi Chang
Shih-Pin Lin
author_sort Hsiang-Ling Wu
collection DOAJ
description Objectives We aimed to investigate the factors associated with variations in postoperative pain trajectories over time in patients using intravenous patient-controlled analgesia (IV-PCA) for postoperative pain.Design Retrospective cohort study.Setting A single medical centre in Taiwan.Participants Patients receiving IV-PCA after surgery.Primary and secondary outcome measures Primary outcome was the postoperative pain scores.Results A total of 3376 patients and 20 838 pain score observations were analysed using latent curve models. Female and longer anaesthesia time increased the baseline level of pain (p=0.004 and 0.003, respectively), but abdominal surgery and body weight decreased it (both p<0.001). Regarding the trend of pain resolution, lower abdominal surgery steepened the slope (p<0.001); older age, American Society of Anesthesiologists (ASA) class ≥3 and longer anaesthesia time tended to flatten the slope (p<0.001, =0.019 and <0.001, respectively). PCA settings did not affect the variations in postoperative pain trajectories.Conclusions Patient demographics, ASA class, anaesthesia time and surgical sites worked together to affect postoperative pain trajectories in patients receiving IV-PCA. Latent curve models provided valuable information about the dynamic and complex relationships between the pain trajectories and their influential factors.
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spelling doaj-art-5890e4c10aef4c1e8272106d8ee25ec92024-11-30T05:10:10ZengBMJ Publishing GroupBMJ Open2044-60552019-11-0191110.1136/bmjopen-2019-031936Influential factors of postoperative pain trajectories in patients receiving intravenous patient-controlled analgesia: a single-centre cohort study in TaiwanHsiang-Ling Wu0Ying-Hsuan Tai1Mei-Yung Tsou2Kuang-Yi Chang3Shih-Pin Lin4School of Medicine, National Yang-Ming University, Taipei, TaiwanDepartment of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan4 School of Medicine, National Yang-Ming University, Taipei, Taiwan4 School of Medicine, National Yang-Ming University, Taipei, Taiwan3 Department of Anaesthesiology, Taipei Veterans General Hospital, Taipei, TaiwanObjectives We aimed to investigate the factors associated with variations in postoperative pain trajectories over time in patients using intravenous patient-controlled analgesia (IV-PCA) for postoperative pain.Design Retrospective cohort study.Setting A single medical centre in Taiwan.Participants Patients receiving IV-PCA after surgery.Primary and secondary outcome measures Primary outcome was the postoperative pain scores.Results A total of 3376 patients and 20 838 pain score observations were analysed using latent curve models. Female and longer anaesthesia time increased the baseline level of pain (p=0.004 and 0.003, respectively), but abdominal surgery and body weight decreased it (both p<0.001). Regarding the trend of pain resolution, lower abdominal surgery steepened the slope (p<0.001); older age, American Society of Anesthesiologists (ASA) class ≥3 and longer anaesthesia time tended to flatten the slope (p<0.001, =0.019 and <0.001, respectively). PCA settings did not affect the variations in postoperative pain trajectories.Conclusions Patient demographics, ASA class, anaesthesia time and surgical sites worked together to affect postoperative pain trajectories in patients receiving IV-PCA. Latent curve models provided valuable information about the dynamic and complex relationships between the pain trajectories and their influential factors.https://bmjopen.bmj.com/content/9/11/e031936.full
spellingShingle Hsiang-Ling Wu
Ying-Hsuan Tai
Mei-Yung Tsou
Kuang-Yi Chang
Shih-Pin Lin
Influential factors of postoperative pain trajectories in patients receiving intravenous patient-controlled analgesia: a single-centre cohort study in Taiwan
BMJ Open
title Influential factors of postoperative pain trajectories in patients receiving intravenous patient-controlled analgesia: a single-centre cohort study in Taiwan
title_full Influential factors of postoperative pain trajectories in patients receiving intravenous patient-controlled analgesia: a single-centre cohort study in Taiwan
title_fullStr Influential factors of postoperative pain trajectories in patients receiving intravenous patient-controlled analgesia: a single-centre cohort study in Taiwan
title_full_unstemmed Influential factors of postoperative pain trajectories in patients receiving intravenous patient-controlled analgesia: a single-centre cohort study in Taiwan
title_short Influential factors of postoperative pain trajectories in patients receiving intravenous patient-controlled analgesia: a single-centre cohort study in Taiwan
title_sort influential factors of postoperative pain trajectories in patients receiving intravenous patient controlled analgesia a single centre cohort study in taiwan
url https://bmjopen.bmj.com/content/9/11/e031936.full
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