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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2.	中華醫學會胸心血管外科學分會胸腔鏡外科學組, 中國醫師協會胸外科醫師分會微創外科專家委員會. 中國胸外科圍手術期疼痛管理專家共識(2018版). 中國胸心血管外科臨床雜志, 2018, 25(11): 921-928.
3.	郭云觀, 馮藝. 亦敵亦友—術后阿片類藥物鎮痛研究進展. 中國疼痛醫學雜志, 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.
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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.	中華醫學會麻醉學分會. 成人手術后疼痛處理專家共識. 臨床麻醉學雜志, 2017, 33(9): 911-917.
14.	中國抗癌協會腫瘤麻醉與鎮痛專業委員會. 中國腫瘤患者圍術期疼痛管理專家共識(2020版). 中國腫瘤臨床, 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.	李國先. 2016年廣東省12家醫院術后鎮痛現狀的調查. 廣州醫科大學, 2017. 1-57.
17.	黑子清, 靳三慶, 李雅蘭, 等. 成人術后急性疼痛PCIA治療規范化管理建議. 臨床麻醉學雜志, 2018, 34(2): 187-190.
18.	王娟, 陳德鳳, 劉勇世, 等. 肺葉切除術患者術后慢性疼痛的影響因素分析. 臨床醫學研究與實踐, 2019, 4(23): 102-104.
19.	王超. 早期非小細胞肺癌患者肺葉切除術后急慢性疼痛的危險因素分析. 北京市結核病胸部腫瘤研究所, 2017. 1-54.
20.	劉禮鋒, 萬凌峰, 孟齊生, 等. 外科手術后疼痛與年齡、性別間的相關性分析. 浙江創傷外科, 2018, 23(2): 233-234.
21.	林治, 潘鴻錦, 鄭學銘, 等. 胸腔鏡肺葉切除聯合縱隔淋巴結清掃在肺癌患者治療中的效果及安全性分析. 福建醫藥雜志, 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.

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin, 2018, 68(1): 7-30.
2. 中華醫學會胸心血管外科學分會胸腔鏡外科學組, 中國醫師協會胸外科醫師分會微創外科專家委員會. 中國胸外科圍手術期疼痛管理專家共識(2018版). 中國胸心血管外科臨床雜志, 2018, 25(11): 921-928.
3. 郭云觀, 馮藝. 亦敵亦友—術后阿片類藥物鎮痛研究進展. 中國疼痛醫學雜志, 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. 支夢佳, 魏興梅, 高翔, 等. 我國阿片類鎮痛藥物臨床使用現狀分析. 藥物流行病學雜志, 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. 中華醫學會麻醉學分會. 成人手術后疼痛處理專家共識. 臨床麻醉學雜志, 2017, 33(9): 911-917.
14. 中國抗癌協會腫瘤麻醉與鎮痛專業委員會. 中國腫瘤患者圍術期疼痛管理專家共識(2020版). 中國腫瘤臨床, 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. 李國先. 2016年廣東省12家醫院術后鎮痛現狀的調查. 廣州醫科大學, 2017. 1-57.
17. 黑子清, 靳三慶, 李雅蘭, 等. 成人術后急性疼痛PCIA治療規范化管理建議. 臨床麻醉學雜志, 2018, 34(2): 187-190.
18. 王娟, 陳德鳳, 劉勇世, 等. 肺葉切除術患者術后慢性疼痛的影響因素分析. 臨床醫學研究與實踐, 2019, 4(23): 102-104.
19. 王超. 早期非小細胞肺癌患者肺葉切除術后急慢性疼痛的危險因素分析. 北京市結核病胸部腫瘤研究所, 2017. 1-54.
20. 劉禮鋒, 萬凌峰, 孟齊生, 等. 外科手術后疼痛與年齡、性別間的相關性分析. 浙江創傷外科, 2018, 23(2): 233-234.
21. 林治, 潘鴻錦, 鄭學銘, 等. 胸腔鏡肺葉切除聯合縱隔淋巴結清掃在肺癌患者治療中的效果及安全性分析. 福建醫藥雜志, 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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