Key result
The use of postoperative epidural analgesia and IV-PCA were significant predictors of early postoperative pain, with overall median pain scores of 3 on day 1 and 2 on days 2 and 3.
Why the study?
Postoperative analgesia has not been adequately addressed in Japan, prompting this evaluation of the relationship between postoperative pain, recovery, and hospital stay.
Do postoperative epidural analgesia and IV-PCA reduce early postoperative pain in patients undergoing major surgery?
Observational
Yes
Do postoperative epidural analgesia and IV-PCA reduce early postoperative pain in patients undergoing major surgery?
The use of epidural analgesia and/or IV-PCA effectively reduces early postoperative pain, which is a significant predictor of recovery quality and hospital stay length after major surgery.
This is the authors' abstract. We don't add key points for this paper.
Background/Objectives: Postoperative analgesia is important for reducing biologically invasive reactions to surgery. In Japan, postoperative analgesia, including indices of analgesia, has not been adequately addressed. This study aimed to determine the relationship between postoperative pain and postoperative course and the importance of analgesia for early recovery. Methods: Patients who underwent any of seven surgical procedures in gastrointestinal, thoracic, and cardiac surgery were enrolled. The primary endpoint was a median Prince Henry Pain Scale score from postoperative days 1 to 3. Secondary endpoints were the quality of recovery on postoperative day 7 (Quality of Recovery-15 [QoR-15]) and the length of postoperative hospital stay. Results: Median postoperative pain levels among surgeries were 3 on day 1, 2 on days 2 and 3, 1 on day 7, and 1 at discharge. In both univariate and multivariate analyses, the use of postoperative epidural analgesia and intravenous patient-controlled analgesia (IV-PCA) were significant predictors of early postoperative pain. Only early postoperative pain was a significant predictor of QoR-15 score. Regular use of acetaminophen, early postoperative pain, no appetite, and postoperative complications were significant in affecting the length of postoperative hospital stay. In the comparison of early postoperative pain according to whether epidural analgesia and IV-PCA were used, the group that used both methods had the least pain. Conclusions: In Japan, early postoperative pain persists after major surgical procedures and affects postoperative quality of recovery and length of hospital stay. The use of epidural analgesia, IV-PCA, or both appeared to be effective in overcoming early postoperative pain, thereby enhancing early postoperative recovery.
Answers are grounded in this paper and cite their sources.
Epidural and IV-PCA use associated with early postoperative pain scores; leaves open causal efficacy and requires randomized trials before practice change.
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Kaibori et al. (2025) conducted an observational in Postoperative pain. Postoperative epidural analgesia and intravenous patient-controlled analgesia (IV-PCA) vs. No epidural analgesia or IV-PCA was evaluated on Median Prince Henry Pain Scale score from postoperative days 1 to 3. The use of postoperative epidural analgesia and IV-PCA were significant predictors of early postoperative pain, with overall median pain scores of 3 on day 1 and 2 on days 2 and 3.
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