Modeling the Trajectory of Analgesic Demand Over Time After Total Knee Arthroplasty Using the Latent Curve Analysis

Lo, Po Han; Tsou, Mei-Yung; Chang, Kuang Yi

doi:10.1097/ajp.0000000000000172

Cited by 10 publications

(6 citation statements)

References 16 publications

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“…In another study (n ¼ 102), women showed a longer duration of postoperative pain within the first 6 weeks after open or arthroscopic rotator cuff repair (33 vs. 26 days in men, P ¼ 0.03), but prevalence of residual pain did not significantly differ (62 vs. 41%, P ¼ 0.11) [27]. In contrast, women had a more rapid decrease in analgesic demand in the first 48 h after total knee arthroplasty (n ¼ 916) [28]. Gender was not associated with differences in postoperative pain after ankle fracture surgery (n ¼ 137) [29] or after hallux valgus surgery (n ¼ 130) [30] and was not associated with the risk of developing a complex regional pain syndrome during hospitalization after open reduction and internal fixation for limb surgery (cohort study with n ¼ 185 378, 39 of which developed a complex regional pain syndrome) [31].…”

Section: Orthopedic Surgerymentioning

confidence: 72%

Gender aspects in postoperative pain

Pereira

Pogatzki-Zahn

2015

Current Opinion in Anaesthesiology

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Section: Orthopedic Surgerymentioning

confidence: 72%

Gender aspects in postoperative pain

Pereira

Pogatzki-Zahn

2015

Current Opinion in Anaesthesiology

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“…A backward model selection strategy was used to identify explanatory variables of the intercept and slope parameters and determine the final multiple predictors model. The details of statistical technique on latent curve analysis refer to the previous literature (12). The root mean square error of approximation (RMSEA) was used to evaluate the model fit and the values of <0.1 indicated acceptable model fit (13).…”

Section: Discussionmentioning

confidence: 99%

Associations of Multimodal Analgesia With Postoperative Pain Trajectories and Morphine Consumption After Hepatic Cancer Surgery

Yeh

Chang

et al. 2022

Front. Med.

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BackgroundThis study aimed to investigate the influential factors of postoperative pain trajectories and morphine consumption after hepatic cancer surgery with a particular interest in multimodal analgesia.MethodsPatients receiving hepatic cancer surgery at a tertiary medical center were enrolled between 2011 and 2016. Postoperative pain scores and potentially influential factors like patient characteristics and the analgesic used were collected. Latent curve analysis was conducted to investigate predictors of postoperative pain trajectories and a linear regression model was used to explore factors associated with postoperative morphine consumption.Results450 patients were collected, the daily pain scores during the first postoperative week ranged from 2.0 to 3.0 on average. Male and higher body weight were associated with more morphine consumption (both P < 0.001) but reduced morphine demand was noted in the elderly (P < 0.001) and standing acetaminophen users (P = 0.003). Longer anesthesia time was associated with higher baseline pain levels (P < 0.001). In contrast, male gender (P < 0.001) and standing non-steroidal anti-inflammatory drugs (NSAIDs) use (P = 0.012) were associated with faster pain resolution over time.ConclusionsMultimodal analgesia with standing acetaminophen and NSAIDs had benefits of opioid-sparing and faster pain resolution, respectively, to patients receiving hepatic cancer surgery.

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“…IVPCA was typically administered by an ambulatory infusion pump (Gemstar Yellow, Hospira, IL) programmed to deliver morphine continuously with infusion rates of 0.5 to 1.0 mg hr −1 and boluses of 1 mg with a lockout time of 6 minutes. [13,14] The pain service team followed the response of patients receiving IVPCA on a daily basis, and if there were adverse effects of morphine (e.g., nausea, itchiness, and others) or inadequate pain control, the infusion rate or bolus dose of IVPCA would be adjusted accordingly. In most patients, IVPCA was continued for 48 to 72 hours after surgery and switched to oral acetaminophen or nonsteroidal anti-inflammatory drugs thereafter.…”

Section: Methodsmentioning

confidence: 99%

Does postoperative morphine consumption for acute surgical pain impact oncologic outcomes after colorectal cancer resection?

Tai

Chang

et al. 2019

Medicine

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Whether morphine used in human cancer surgery would exert tumor-promoting effects is unclear. This study aimed to investigate the effects of morphine dose on cancer prognosis after colorectal cancer (CRC) resection. In a retrospective study, 1248 patients with stage I through IV CRC undergoing primary tumor resections and using intravenous patient-controlled analgesia for acute surgical pain at a tertiary center between October 2005 and December 2014 were evaluated through August 2016. Progression-free survival (PFS) and overall survival (OS) were analyzed using proportional hazards regression models. Multivariable analysis demonstrated no dose-dependent association between the amount of morphine dose and PFS (adjusted hazard ratio, HR = 1.31, 95% confidence interval, CI = 0.85–2.03) or OS (adjusted HR = 0.86, 95% CI = 0.47–1.55). Patients were further classified into the high-dose and low-dose groups by the median of morphine consumption (49.7 mg), and the morphine doses were mean 75.5 ± standard deviation 28.8 mg and 30.1 ± 12.4 mg in high-dose and low-dose groups, respectively. Multivariable models showed no significant difference in PFS or OS between groups, either (adjusted HR = 1.24, 95% CI = 0.97–1.58 for PFS; adjusted HR = 1.01, 95% CI = 0.71–1.43 for OS). Our results did not support a definite association between postoperative morphine consumption and cancer progression or all-cause mortality in patients following CRC resection.

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Modeling the Trajectory of Analgesic Demand Over Time After Total Knee Arthroplasty Using the Latent Curve Analysis

Abstract: Latent curve analysis provided valuable information about how analgesic demand after TKA changed over time and how patient characteristics affected its trajectory.

Cited by 10 publications

References 16 publications

Gender aspects in postoperative pain

Gender aspects in postoperative pain

Associations of Multimodal Analgesia With Postoperative Pain Trajectories and Morphine Consumption After Hepatic Cancer Surgery

Does postoperative morphine consumption for acute surgical pain impact oncologic outcomes after colorectal cancer resection?

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