• Minerva anestesiologica · Aug 2016

    The Impact of patient controlled analgesia on prognosis of patients receiving major abdominal surgery.

    • Lihua Peng, Li Ren, Peipei Qin, and Min Su.
    • Department of Anesthesia and Pain Medicine, First Affiliated Hospital of Chongqing Medical University, Chongqing, China - plhbest@163.com.
    • Minerva Anestesiol. 2016 Aug 1; 82 (8): 827-38.

    BackgroundPostoperative pain is a major disease burden after surgery. Patient-controlled analgesia has been wide used for pain management in surgical patients, yet, large-scaled studies are lacking to assess its impact on the prognosis of patients.MethodsWe prospectively enrolled patients who underwent major abdominal surgeries receiving patient-controlled analgesia (PCA) and who received non-PCA for assessment of 60-day mortality, major postoperative complications using electronic medical chart system. Pain intensity was also assessed with visual analogue scale from postoperative day 1 to day 7, chronic post-surgical pain was assessed by telephone follow-up using numerical rating scale.ResultsIn total, 12,015 patients were included in the primary analysis. At the end of the follow-up, 1185 patients were lost to follow-up. Patients in the non-PCA group reported increased incidence of moderate-to-severe pain on postoperative day 3 (6.5% versus 9.6%, P<0.001). Patients receiving non-PCA had increased mortalities on postoperative 60-day (1.02% versus 0.47%, P<0.001). The survival probability of patients in PCA group was statistically higher than those in non-PCA group (99.52% [95% CI: 99.34-99.70%] versus 98.97% [95% CI: 98.73-99.92%]). Patient receiving non-PCA reported increased in-hospital major complications compared with (2.7% versus 1.9 %, P=0.003). Pain intensity was also assessed with visual analogue scale from postoperative day 1 to day 7, chronic post-surgical pain was assessed by telephone follow-up using numerical rating scale.ConclusionsIntravenous patient-controlled analgesia was related to improved survival, less complications and chronic post-surgical pain after major abdominal surgery, reiterating the important role of pain management for the prognosis of patients who underwent surgery.

      Pubmed     Free full text   Copy Citation  

      Add institutional full text...

    Notes

    hide…