Risk factors for discontinuing intravenous patient-controlled analgesia after thoracic surgery

• Published in: Annals of thoracic medicine 2024-01, Vol.19 (1), p.81-86
• Main Authors: Kim, Saeyeon, Shih, Beatrice Chia-Hui, Song, In-Ae, Oh, Tak Kyu
• Format: Article
• Language: English
• Subjects: analgesia; Care and treatment; Esophageal cancer; esophageal cancer surgery; Esophagus; Medical research; Medicine, Experimental; opioid; Original; Pain; Pain management; Patients; Remifentanil; Risk factors; side effects; Thoracic surgery
• ISSN: 1817-1737; 1998-3557
• DOI: 10.4103/atm.atm_159_23

This study examined the risk factors of experiencing side effects from using intravenous patient-controlled analgesia (IV PCA) following lung and esophageal surgery. Our study included adult patients who underwent lung or esophageal surgery and received IV PCA for postoperative acute pain control between 2020 and 2022. We collected information on side effects from IV PCA use, the decision to discontinue PCA, and the PCA regimen from the daily reports of the acute pain management team and verified the accuracy using electronic records from ward nurses. The primary outcome was the risk factor associated with discontinuing IV PCA due to its side effects. Out of the 1796 patients in our study, 1795 used PCA containing opioids; 196 patients stopped IV PCA due to unbearable side effects. Being female (adjusted odds ratio [aOR]: 2.65, 95% confidence interval [CI]: 1.70, 4.13) was linked to a higher chance of stopping PCA use. Having hypertension (aOR: 0.46, 95% CI: 0.26, 0.81) and being classified as the American Society of Anesthesiologists class 3 or higher (aOR: 0.48, 95% CI: 0.23, 0.86) were associated with a lower chance of discontinuing PCA use. Our study determined the risk factors to stop using IV PCA due to side effects following lung or esophageal surgery. These results emphasize the need for personalized pain management plans that take into account the patient's characteristics and the type of surgery performed.