Predicting Procedure-specific Morphine Consumption of Intravenous Patient-controlled Analgesia With Random-effect Model Approach

Clin J Pain. 2019 Jan;35(1):43-49. doi: 10.1097/AJP.0000000000000647.

Abstract

Introduction: Surgical procedure is an important predictor for analgesic consumptions of intravenous patient-controlled analgesia (IV-PCA) for acute pain.

Objectives: The aim of this study was to better fit the analgesic consumptions of IV-PCA with regard to the different surgical procedures.

Materials and methods: A statistical model (random-effect model) was proposed to develop procedure-specific morphine consumptions for various surgical procedures of IV-PCA. After the model was developed, an independent data set was used for external validation.

Results: The results showed a significant influence for morphine consumption coming from surgical procedures. Different surgical procedures resulted in a wide range of morphine consumptions. The surgical procedure with the highest morphine consumption was the resection of the pancreas with open approach (76.92 mg), while the lowest one was for the excision of the uterus with open method (34.3 mg). The external validation showed good model performance. The quantitative rank for surgical procedures was also presented.

Discussion: Adopted IV-PCA regimens for different surgical procedures are therefore strongly recommended and incorporated into postoperative acute pain management.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intravenous
  • Aged
  • Analgesia, Patient-Controlled / statistics & numerical data*
  • Analgesics, Opioid / administration & dosage*
  • Analgesics, Opioid / therapeutic use*
  • Female
  • Humans
  • Hysterectomy / adverse effects
  • Male
  • Middle Aged
  • Models, Statistical
  • Morphine / administration & dosage*
  • Morphine / therapeutic use*
  • Pain Management
  • Pain, Postoperative / drug therapy
  • Pancreas / surgery
  • Predictive Value of Tests
  • Reproducibility of Results
  • Retrospective Studies
  • Surgical Procedures, Operative*

Substances

  • Analgesics, Opioid
  • Morphine