• Can J Anaesth · Mar 2019

    Observational Study

    Effect of cultural background and healthcare environment on postoperative opioid requirement.

    • Alex H Konstantatos, Taidi Zhong, Eldho Paul, Sharon Tsang, Suming Tian, Minjun Liu, Yuyuan Liang, Yuanyuan Tian, Shina Qiao, WuWilliam K KWKKState Key Laboratory of Digestive Disease, Department of Anaesthesia and Intensive Care, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China., and ChanMatthew T VMTVDepartment of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. mtvchan@cuhk.edu.hk..
    • Department of Anaesthesia and Perioperative Medicine, Alfred Hospital, Monash University, Melbourne, VIC, Australia.
    • Can J Anaesth. 2019 Mar 1; 66 (3): 309-317.

    PurposeThe objective of this prospective observational study was to investigate the interactions between cultural background, healthcare environment, and postoperative pain experience.MethodsWe enrolled 128 Chinese patients living in rural mainland China and 134 patients in Hong Kong with a higher level of Western cultural influences (defined by educational attainment, place of residence, and ability to understand English). All patients had major abdominal surgery and received patient-controlled analgesia with intravenous morphine for postoperative pain relief. The primary endpoint was total opioid requirement up to 48 hr after surgery. Other measures included pain intensity, opioid-related side effects, and genetic markers for opioid responsiveness.ResultsThe mean (95% confidence interval) cumulative opioid requirement, expressed as morphine equivalent, during the first 48 hr after surgery was significantly less in patients from mainland China (18.8 [15.7 to 22] mg) compared with patients from Hong Kong (42.0 [38.3 to 45.6] mg, P < 0.0001). In a multivariable analysis, opioid requirement was influenced by ethnicity, duration of surgery, and severity of pain upon admission to the postanesthetic care unit.ConclusionsThese results suggest that postoperative pain behaviours and opioid requirement may be influenced by cultural background and healthcare environment in two populations of Chinese descent.Trial RegistrationAustralian and New Zealand Clinical Trials Registry (ACTRN12614000601639); registered 6 May, 2014.

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