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Purpose <p>We investigated the incidence and predictors of moderate-to-severe movement-evoked pain (MEP) following gastrointestinal and hepatobiliary surgery and compare the findings for postoperative day one (POD1; Study A) and those for postoperative day three (POD3; Study B).</p> Methods <p>We retrospectively enrolled 1698 adult patients who underwent gastrointestinal or hepatobiliary surgery under general anesthesia. Postoperative MEP and resting pain were evaluated using an 11-point numerical rating scale (NRS), with moderate-to-severe pain defined as a score of ≥ 4. Information on perioperative variables was obtained from medical records, and binary logistic regression was performed to identify possible predictors.</p> Results <p>On POD1, 54.4% (867/1595) of the patients reported moderate-to-severe MEP (Study A). Among those with moderate-to-severe MEP on either POD1 or postoperative day two, 63.1% (311/493) continued to experience moderate-to-severe MEP on POD3 (Study B). Risk factors of moderate-to-severe MEP on POD1 included young age (OR: 1.33, 95% CI 1.08–1.64), male gender (OR: 1.47, 95% CI 1.20–1.81) and preoperative pain (OR: 1.47, 95% CI 1.16–1.88), while epidural analgesia (OR: 0.61, 95% CI 0.50–0.75) was protective. Until POD3, overweight (OR: 1.65, 95% CI 1.03–2.65) and larger incision size (OR: 1.62, 95% CI 1.07–2.45) were identified as risk factors, while postoperative acetaminophen (APAP) alone (OR: 0.33, 95% CI 0.12–0.91) and APAP combined with non-steroidal anti-inflammatory drugs (OR: 0.26, 95% CI 0.09–0.71) were protective.</p> Conclusion <p>More than a half of the patients with moderate-to-severe MEP on POD1 or POD2 continued to experience it on POD3. Distinct predictors for moderate-to-severe MEP on POD1 and POD3 were identified.</p>

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Incidences and predictors of moderate-to-severe movement-evoked pain until postoperative day three following gastrointestinal and hepatobiliary surgery: a retrospective study

  • 期刊论文

  • 发表日期：

    2025年6月24日

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  • Wei Si,
  • Kumiko Ishida,
  • Takashi Ishida,
  • Satoshi Tanaka

摘要

Purpose

We investigated the incidence and predictors of moderate-to-severe movement-evoked pain (MEP) following gastrointestinal and hepatobiliary surgery and compare the findings for postoperative day one (POD1; Study A) and those for postoperative day three (POD3; Study B).

Methods

We retrospectively enrolled 1698 adult patients who underwent gastrointestinal or hepatobiliary surgery under general anesthesia. Postoperative MEP and resting pain were evaluated using an 11-point numerical rating scale (NRS), with moderate-to-severe pain defined as a score of ≥ 4. Information on perioperative variables was obtained from medical records, and binary logistic regression was performed to identify possible predictors.

Results

On POD1, 54.4% (867/1595) of the patients reported moderate-to-severe MEP (Study A). Among those with moderate-to-severe MEP on either POD1 or postoperative day two, 63.1% (311/493) continued to experience moderate-to-severe MEP on POD3 (Study B). Risk factors of moderate-to-severe MEP on POD1 included young age (OR: 1.33, 95% CI 1.08–1.64), male gender (OR: 1.47, 95% CI 1.20–1.81) and preoperative pain (OR: 1.47, 95% CI 1.16–1.88), while epidural analgesia (OR: 0.61, 95% CI 0.50–0.75) was protective. Until POD3, overweight (OR: 1.65, 95% CI 1.03–2.65) and larger incision size (OR: 1.62, 95% CI 1.07–2.45) were identified as risk factors, while postoperative acetaminophen (APAP) alone (OR: 0.33, 95% CI 0.12–0.91) and APAP combined with non-steroidal anti-inflammatory drugs (OR: 0.26, 95% CI 0.09–0.71) were protective.

Conclusion

More than a half of the patients with moderate-to-severe MEP on POD1 or POD2 continued to experience it on POD3. Distinct predictors for moderate-to-severe MEP on POD1 and POD3 were identified.