Use of opioid analgesics during postoperative hospitalization in patients undergoing lung resection and its influencing factors: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Yuanqiang ¹ , WEI Xing ² , XIE Shaohua ² , WANG Yaqin ² , LIAO Jia ² , XU Wei ³ , PU Yang ³ , SHI Qiuling ^3,4 , LI Qiang ² ,  DAI Wei ² ,  DONG Jifu ⁵

1. Department of Cardiothoracic Surgery, Zigong First People's Hospital, Zigong, 643000, Sichuan, P. R. China;
2. Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, P. R. China;
3. School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, P. R. China;
4. Center for Cancer Prevention Research, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, P. R. China;
5. Department of Anesthesiology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, P. R. China;

Corresponding author：

DAI Wei, Email: daiwei@sichuancancer.org; DONG Jifu, Email: Jeffdonw719@163.com

Keywords：

Lung cancer; surgery; postoperative hospitalization; pain; opioid analgesics; influencing factor

DOI：

10.7507/1007-4848.202012119

Video：

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Objective To investigate the use of opioid analgesics during the postoperative hospitalization in patients undergoing lung resection and analyse its influencing factors.Methods The clinical data of 450 patients undergoing lung resection in Sichuan Cancer Hospital among a multicenter symptom research database (CN-PRO-Lung 1) between November 2017 and January 2020 were analyzed. There were 248 males and 202 females with an average age of 54.7±10.3 years.Results A total of 448 (99.6%) patients used opioid analgesics. The average daily morphine equivalent dose during the postoperative hospitalization was 48.9 mg. There were statistical differences in postoperative morphine equivalent dose across patients with different sex, age, highest level of education, Charlson Comorbidity Index score, surgical approach, surgical type, operative time, postoperative hospital stay and grade of postoperative complications (all P<0.05). Multivariate analysis showed that sex, surgical approach and postoperative hospital stay were independent influencing factors for morphine use during the postoperative hospitalization in patients undergoing lung resection (all P<0.05).Conclusion In clinical practice, attention should be paid to postoperative pain for male patients, as well as to promote the application of minimally invasive surgery, and to shorten the length of postoperative hospital stay, in order to ultimately reduce the use of opioids.

Citation： ZHANG Yuanqiang, WEI Xing, XIE Shaohua, WANG Yaqin, LIAO Jia, XU Wei, PU Yang, SHI Qiuling, LI Qiang, DAI Wei, DONG Jifu. Use of opioid analgesics during postoperative hospitalization in patients undergoing lung resection and its influencing factors: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(7): 909-913. doi: 10.7507/1007-4848.202012119 Copy

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1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin, 2018, 68(1): 7-30.
2. 中华医学会胸心血管外科学分会胸腔镜外科学组, 中国医师协会胸外科医师分会微创外科专家委员会. 中国胸外科围手术期疼痛管理专家共识(2018版). 中国胸心血管外科临床杂志, 2018, 25(11): 921-928.
3. 郭云观, 冯艺. 亦敌亦友—术后阿片类药物镇痛研究进展. 中国疼痛医学杂志, 2017, 23(10): 721-726.
4. Wall T, Sherwin A, Ma D, et al. Influence of perioperative anaesthetic and analgesic interventions on oncological outcomes: A narrative review. Br J Anaesth, 2019, 123(2): 135-150.
5. Grandhi RK, Lee S, Abd-Elsayed A. Does opioid use cause angiogenesis and metastasis? Pain Med, 2017, 18(1): 140-151.
6. Pommerening MJ, Landau A, Hrebinko K, et al. An analysis of analgesia and opioid prescribing for veterans after thoracic surgery. Sci Rep, 2020, 10(1): 11348.
7. Seth P, Rudd RA, Noonan RK, et al. Quantifying the epidemic of prescription opioid overdose deaths. Am J Public Health, 2018, 108(4): 500-502.
8. 支梦佳, 魏兴梅, 高翔, 等. 我国阿片类镇痛药物临床使用现状分析. 药物流行病学杂志, 2018, 27(6): 400-405.
9. Dai W, Xie S, Zhang R, et al. Developing and validating utility parameters to establish patient-reported outcome-based perioperative symptom management in patients with lung cancer: A multicentre, prospective, observational cohort study protocol. BMJ Open, 2019, 9(10): e030726.
10. Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis, 1987, 40(5): 373-383.
11. Sankar A, Johnson SR, Beattie WS, et al. Reliability of the American Society of Anesthesiologists physical status scale in clinical practice. Br J Anaesth, 2014, 113(3): 424-432.
12. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg, 2004, 240(2): 205-213.
13. 中华医学会麻醉学分会. 成人手术后疼痛处理专家共识. 临床麻醉学杂志, 2017, 33(9): 911-917.
14. 中国抗癌协会肿瘤麻醉与镇痛专业委员会. 中国肿瘤患者围术期疼痛管理专家共识(2020版). 中国肿瘤临床, 2020, 47(14): 703-710.
15. Cho HE, Hu HM, Gunaseelan V, et al. Does surgical intensity correlate with opioid prescribing?: Classifying common surgical procedures. Ann Surg, 2022, 275(5): 897-903..
16. 李国先. 2016年广东省12家医院术后镇痛现状的调查. 广州医科大学, 2017. 1-57.
17. 黑子清, 靳三庆, 李雅兰, 等. 成人术后急性疼痛PCIA治疗规范化管理建议. 临床麻醉学杂志, 2018, 34(2): 187-190.
18. 王娟, 陈德凤, 刘勇世, 等. 肺叶切除术患者术后慢性疼痛的影响因素分析. 临床医学研究与实践, 2019, 4(23): 102-104.
19. 王超. 早期非小细胞肺癌患者肺叶切除术后急慢性疼痛的危险因素分析. 北京市结核病胸部肿瘤研究所, 2017. 1-54.
20. 刘礼锋, 万凌峰, 孟齐生, 等. 外科手术后疼痛与年龄、性别间的相关性分析. 浙江创伤外科, 2018, 23(2): 233-234.
21. 林治, 潘鸿锦, 郑学铭, 等. 胸腔镜肺叶切除联合纵隔淋巴结清扫在肺癌患者治疗中的效果及安全性分析. 福建医药杂志, 2020, 42(3): 100-102.
22. Khullar OV, Rajaei MH, Force SD, et al. Pilot study to integrate patient reported outcomes after lung cancer operations into the Society of Thoracic Surgeons Database. Ann Thorac Surg, 2017, 104(1): 245-253.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Use of opioid analgesics during postoperative hospitalization in patients undergoing lung resection and its influencing factors: A retrospective cohort study

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