Postoperative Pain in Patients Undergoing Cancer Surgery and Intravenous Patient-Controlled Analgesia Use: The First and Second 24 h Experiences

Chen, Xiaohong; Yao, Jiazhen; Xin, Yirong; Ma, Genshan; Yu, Yan; Yang, Yuan; Shu, Xiaochen; Cao, Hanzhong

doi:10.1007/s40122-022-00459-w

Cited by 4 publications

(3 citation statements)

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“…Remifentanil is a highly strong and extremely short-acting opioid medication that is commonly used in general anaesthesia (Santonocito et al, 2018). We identified higher use doses of remifentanil as a risk factor for more intense post-operative pain, which aligns with previous research (Chen et al, 2023). Reasons may be that its use was not only associated with longer operative time but also with a rise in pain sensitivity following the use of remifentanil during surgery (Ren et al, 2023).…”

Section: Surgical Related Factors: Consumption Of Intraoperative Remi...supporting

confidence: 76%

Development of a nomogram for predicting acute pain among patients after abdominal surgery: A prospective observational study

Wang,

Qin,

Zhen

et al. 2024

Journal of Clinical Nursing

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AimsTo develop a nomogram to provide a screening tool for recognising patients at risk of post‐operative pain undergoing abdominal operations.BackgroundRisk prediction models for acute post‐operative pain can allow initiating prevention strategies, which are valuable for post‐operative pain management and recovery. Despite the increasing number of studies on risk factors, there were inconsistent findings across different studies. In addition, few studies have comprehensively explored predictors of post‐operative acute pain and built prediction models.DesignA prospective observational study.MethodsA total of 352 patients undergoing abdominal operations from June 2022 to December 2022 participated in this investigation. A nomogram was developed for predicting the probability of acute pain after abdominal surgery according to the results of binary logistic regression. The nomogram's predictive performance was assessed by discrimination and calibration. Internal validation was performed via Bootstrap with 1000 re‐samplings.ResultsA total of 139 patients experienced acute post‐operative pain following abdominal surgery, with an incidence of 39.49%. Age <60, marital status (unmarried, divorced, or widowed), consumption of intraoperative remifentanil >2 mg, indwelling of drainage tubes, poor quality sleep, high pain catastrophizing, low pain self‐efficacy, and PCIA not used were predictors of inadequate pain control in patients after abdominal surgery. Using these variables, we developed a nomogram model. All tested indicators showed that the model has reliable discrimination and calibration.ConclusionsThis study established an online dynamic predictive model that can offer an individualised risk assessment of acute pain after abdominal surgery. Our model had good differentiation and calibration and was verified internally as a useful tool for risk assessment.Relevance to Clinical PracticeThe constructed nomogram model could be a practical tool for predicting the risk of experiencing acute post‐operative pain in patients undergoing abdominal operations, which would be helpful to realise personalised management and prevention strategies for post‐operative pain.Reporting MethodThe Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were adopted in this study.Patient or Public ContributionBefore the surgery, research group members visited the patients who met the inclusion criteria and explained the purpose and scope of the study to them. After informed consent, they completed the questionnaire. The patients' pain scores (VAS) were regularly assessed and documented by the bedside nurse for the first 3 days following surgery. Other information was obtained from medical records.

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Section: Surgical Related Factors: Consumption Of Intraoperative Remi...supporting

confidence: 76%

Development of a nomogram for predicting acute pain among patients after abdominal surgery: A prospective observational study

Wang,

Qin,

Zhen

et al. 2024

Journal of Clinical Nursing

View full text Add to dashboard Cite

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“…Moreover, postoperative opioid requirements may vary among patients. Therefore, a fixed dosing schedule can be an underdose for some patients with special needs and an overdose for others [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Pain in High-Dose-Rate Brachytherapy for Cervical Cancer: A Retrospective Cohort Study

Becerra-Bolaños,

Jiménez-Gil,

Federico

et al. 2023

JPM

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High-dose-rate brachytherapy (HDR) is part of the main treatment for locally advanced uterine cervical cancer. Our aim was to evaluate the incidence and intensity of pain and patients’ satisfaction during HDR. Risk factors for suffering pain were also analyzed. A retrospective study was carried out by extracting data from patients who had received HDR treatment for five years. Postoperative analgesia had been administered using pre-established analgesic protocols for 48 h. Pain assessment was collected according to a protocol by the acute pain unit. Analgesic assessment was compared according to analgesic protocol administered, number of needles implanted, and type of anesthesia performed during the procedure. From 172 patients treated, data from 247 treatments were analyzed. Pain was considered moderate in 18.2% of the patients, and 43.3% of the patients required at least one analgesic rescue. Patients receiving major opioids reported worse pain control. No differences were found regarding the analgesic management according to the intraprocedural anesthesia used or the patients’ characteristics. The number of inserted needles did not influence the postoperative analgesic assessment. Continuous intravenous infusion of tramadol and metamizole made peri-procedural pain during HDR mild in most cases. Many patients still suffered from moderate pain.

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“…During the process of treatment, most patients are exposed to intense multimodal therapies, including diverse invasive procedures, surgery, chemotherapy, and radiation ( 2 ). To some extent, all above mentioned therapies result in pain, with the tumor resection surgeries estimated to be the most painful ( 3 ). If not treated promptly, postoperative pain can have significant sequelae on physical and mental health ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Regional anesthesia for pain control in children with solid tumors—a review of case reports

Baizhanova,

Zhailauova,

Sazonov

2024

Front. Pediatr.

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IntroductionAround seventy percent of all childhood cancer patients suffer from severe pain. This pain can arise from various sources, including tumors themselves, pain caused by metastasizing tumor cells or as the outcome of therapy meant to deal with tumors. If managed inadequately, such pain can lead to many hazardous sequelae. However, there are extreme cases when pain does not respond to standard treatment. For such cases, regional anesthesia or nerve blocks are utilized as the utmost pain control measure. Blocks are used to treat pain in patients who no longer respond to conventional opioid-based treatment or whose worsened condition makes it impossible to receive any other therapy. The data regarding the use of regional anesthesia for such cases in the children population is limited.MethodsFor this review we searched for case reports in Scopus and PubMed from inception to 2023. The descriptive search items included terms related to childhood cancer and the description of each block. The inclusion criteria for review include children (0-18 years old) receiving oncology-related surgical procedures or palliative care. The data collection was limited to solid tumor-related cases only. We analyzed a total of 38 studies that included case reports and one retrospective study.Results and discussionIt was concluded that nerve blocks, although rarely performed, are a safe and efficient way of pain control in children with solid tumors. The major settings for block performance are postoperative pain control and palliative care. We observed that block indication and its outcomes depend on unique health circumstances in which they should be performed. Patients with similar diagnoses had differing outcomes while receiving the same block treatment.

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Postoperative Pain in Patients Undergoing Cancer Surgery and Intravenous Patient-Controlled Analgesia Use: The First and Second 24 h Experiences

Cited by 4 publications

References 30 publications

Development of a nomogram for predicting acute pain among patients after abdominal surgery: A prospective observational study

Development of a nomogram for predicting acute pain among patients after abdominal surgery: A prospective observational study

Pain in High-Dose-Rate Brachytherapy for Cervical Cancer: A Retrospective Cohort Study

Regional anesthesia for pain control in children with solid tumors—a review of case reports

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