Article title age-related differences in postoperative pain after single-port access adnexal laparoscopy: a three-arm analgesic strategy comparison

Background This study evaluated age-related differences in postoperative pain and analgesic requirements after single-port access (SPA) laparoscopy for adnexal disease under three analgesic regimens. Methods This retrospective cohort study included 470 patients stratified into: <40 years ( n = 257), 40–55 years ( n = 138), and >55 years ( n = 75). Patients received continuous wound infiltration (CWI) alone, intravenous patient-controlled analgesia (IV PCA) alone, or combined CWI + IV PCA. NRS pain scores at 6, 12, 24, and 48 h were the primary outcomes. Multivariable regression adjusted for analgesic regimen, surgery type, and body mass index, with additional adjustment for endometriosis in sensitivity analysis. Results Unadjusted NRS scores did not differ among age groups. Rescue nonsteroidal anti-inflammatory drug use was higher in patients aged <40 years at 0–6, 6–12, and 24–48 h. After adjustment, patients aged <40 years had significantly higher NRS scores at 24 h ( β = 0.276, p = 0.046). Combined CWI and IV PCA was associated with the lowest postoperative pain scores across age groups; however, a formal age × treatment interaction was not statistically significant. Sensitivity analysis yielded consistent findings. Conclusions Younger age (<40 years) was independently associated with modestly higher postoperative pain at 24 h after SPA adnexal laparoscopy, although this difference was below the minimal clinically important difference. These findings may inform individualized analgesic planning, pending confirmation in prospective studies.