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Predictive factors of postoperative fentanyl consumption in patients with inflammatory bowel disease: a retrospective cohort study

BACKGROUND: Patients with inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, might present difficulties in achieving postoperative analgesia. Prior studies have suggested that patients with IBD undergoing major abdominal surgery require higher doses of perioperative...

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Autores principales: Tsuboi, Sayaka, Kubota, Kazumi, Mihara, Takahiro, Taguri, Masataka, Inagawa, Gaku, Goto, Takahisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8915481/
https://www.ncbi.nlm.nih.gov/pubmed/35277136
http://dx.doi.org/10.1186/s12871-022-01606-8
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author Tsuboi, Sayaka
Kubota, Kazumi
Mihara, Takahiro
Taguri, Masataka
Inagawa, Gaku
Goto, Takahisa
author_facet Tsuboi, Sayaka
Kubota, Kazumi
Mihara, Takahiro
Taguri, Masataka
Inagawa, Gaku
Goto, Takahisa
author_sort Tsuboi, Sayaka
collection PubMed
description BACKGROUND: Patients with inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, might present difficulties in achieving postoperative analgesia. Prior studies have suggested that patients with IBD undergoing major abdominal surgery require higher doses of perioperative opioids than do patients without IBD. Considering patients with IBD potentially require high-dose opioids, identifying those requiring higher opioid doses will allow clinicians to optimize the perioperative opioid dose and avoid insufficient pain management or complications of opioid overdose. Therefore, we conducted this study to identify predictive factors that might influence postoperative opioid consumption in patients with IBD. METHODS: This single-center, historical cohort study reviewed the medical records of all patients admitted to the IBD center of our institution for surgery and who used intravenous fentanyl patient-controlled analgesia (PCA) after open abdominal surgery between June 2013 and April 2017. Ultimately, 179 patients were enrolled in the analysis. Variables expected to influence and/or represent pain, analgesia, inflammation, disease condition, and extent of surgery were selected as potential explanatory variables for predicting postoperative opioid consumption. Multivariable linear regression analysis was used to examine the effect of independent variables on postoperative fentanyl consumption. RESULTS: Of the nine predictive variables selected using the stepwise-selection method, eight were significant. Intraoperative fentanyl consumption, current smoking, ulcerative colitis, administration of biologics during the month before surgery, and the use of supplementary analgesics had a significant increasing effect on postoperative fentanyl consumption, whereas droperidol concentration in the PCA solution, age, and diabetes mellitus had a significant decreasing effect. Preoperative use of opioids was a non-significant variable. The adjusted coefficient of determination was 0.302. CONCLUSIONS: Intraoperative fentanyl consumption, current smoking, ulcerative colitis, administration of biologics during the month before surgery, and the use of supplementary analgesics had a significant increasing effect, whereas droperidol concentration in the PCA solution, age, and diabetes mellitus had a significant decreasing effect on postoperative fentanyl consumption. These factors should be considered when adopting postoperative intravenous fentanyl PCA administration for patients with IBD. TRIAL REGISTRATION: Registry: UMIN Clinical Trials Registry. Clinical Trial Number: UMIN000031198. Date of registration: February 8, 2018.
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spelling pubmed-89154812022-03-18 Predictive factors of postoperative fentanyl consumption in patients with inflammatory bowel disease: a retrospective cohort study Tsuboi, Sayaka Kubota, Kazumi Mihara, Takahiro Taguri, Masataka Inagawa, Gaku Goto, Takahisa BMC Anesthesiol Research BACKGROUND: Patients with inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, might present difficulties in achieving postoperative analgesia. Prior studies have suggested that patients with IBD undergoing major abdominal surgery require higher doses of perioperative opioids than do patients without IBD. Considering patients with IBD potentially require high-dose opioids, identifying those requiring higher opioid doses will allow clinicians to optimize the perioperative opioid dose and avoid insufficient pain management or complications of opioid overdose. Therefore, we conducted this study to identify predictive factors that might influence postoperative opioid consumption in patients with IBD. METHODS: This single-center, historical cohort study reviewed the medical records of all patients admitted to the IBD center of our institution for surgery and who used intravenous fentanyl patient-controlled analgesia (PCA) after open abdominal surgery between June 2013 and April 2017. Ultimately, 179 patients were enrolled in the analysis. Variables expected to influence and/or represent pain, analgesia, inflammation, disease condition, and extent of surgery were selected as potential explanatory variables for predicting postoperative opioid consumption. Multivariable linear regression analysis was used to examine the effect of independent variables on postoperative fentanyl consumption. RESULTS: Of the nine predictive variables selected using the stepwise-selection method, eight were significant. Intraoperative fentanyl consumption, current smoking, ulcerative colitis, administration of biologics during the month before surgery, and the use of supplementary analgesics had a significant increasing effect on postoperative fentanyl consumption, whereas droperidol concentration in the PCA solution, age, and diabetes mellitus had a significant decreasing effect. Preoperative use of opioids was a non-significant variable. The adjusted coefficient of determination was 0.302. CONCLUSIONS: Intraoperative fentanyl consumption, current smoking, ulcerative colitis, administration of biologics during the month before surgery, and the use of supplementary analgesics had a significant increasing effect, whereas droperidol concentration in the PCA solution, age, and diabetes mellitus had a significant decreasing effect on postoperative fentanyl consumption. These factors should be considered when adopting postoperative intravenous fentanyl PCA administration for patients with IBD. TRIAL REGISTRATION: Registry: UMIN Clinical Trials Registry. Clinical Trial Number: UMIN000031198. Date of registration: February 8, 2018. BioMed Central 2022-03-11 /pmc/articles/PMC8915481/ /pubmed/35277136 http://dx.doi.org/10.1186/s12871-022-01606-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Tsuboi, Sayaka
Kubota, Kazumi
Mihara, Takahiro
Taguri, Masataka
Inagawa, Gaku
Goto, Takahisa
Predictive factors of postoperative fentanyl consumption in patients with inflammatory bowel disease: a retrospective cohort study
title Predictive factors of postoperative fentanyl consumption in patients with inflammatory bowel disease: a retrospective cohort study
title_full Predictive factors of postoperative fentanyl consumption in patients with inflammatory bowel disease: a retrospective cohort study
title_fullStr Predictive factors of postoperative fentanyl consumption in patients with inflammatory bowel disease: a retrospective cohort study
title_full_unstemmed Predictive factors of postoperative fentanyl consumption in patients with inflammatory bowel disease: a retrospective cohort study
title_short Predictive factors of postoperative fentanyl consumption in patients with inflammatory bowel disease: a retrospective cohort study
title_sort predictive factors of postoperative fentanyl consumption in patients with inflammatory bowel disease: a retrospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8915481/
https://www.ncbi.nlm.nih.gov/pubmed/35277136
http://dx.doi.org/10.1186/s12871-022-01606-8
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