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: Postoperative analgesia is important for reducing biologically invasive reactions to surgery. In Japan, postoperative analgesia, including indices of analgesia, has not been adequately addressed. This study aimed to determine the relationship between postoperative pain and postoperative course and the importance of analgesia for early recovery. : Patients who underwent any of seven surgical procedures in gastrointestinal, thoracic, and cardiac surgery were enrolled. The primary endpoint was a median Prince Henry Pain Scale score from postoperative days 1 to 3. Secondary endpoints were the quality of recovery on postoperative day 7 (Quality of Recovery-15 [QoR-15]) and the length of postoperative hospital stay. : Median postoperative pain levels among surgeries were 3 on day 1, 2 on days 2 and 3, 1 on day 7, and 1 at discharge. In both univariate and multivariate analyses, the use of postoperative epidural analgesia and intravenous patient-controlled analgesia (IV-PCA) were significant predictors of early postoperative pain. Only early postoperative pain was a significant predictor of QoR-15 score. Regular use of acetaminophen, early postoperative pain, no appetite, and postoperative complications were significant in affecting the length of postoperative hospital stay. In the comparison of early postoperative pain according to whether epidural analgesia and IV-PCA were used, the group that used both methods had the least pain. : In Japan, early postoperative pain persists after major surgical procedures and affects postoperative quality of recovery and length of hospital stay. The use of epidural analgesia, IV-PCA, or both appeared to be effective in overcoming early postoperative pain, thereby enhancing early postoperative recovery.
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http://dx.doi.org/10.3390/jcm14041130 | DOI Listing |
Foot Ankle Int
September 2025
Department of Orthopaedic Surgery, St. Luke's University Health Network, Bethlehem, PA, USA.
Background: In response to the opioid epidemic, many surgical specialties have adopted nonopioid pain management strategies. Ultrasound (US)-guided peripheral nerve blocks (PNBs) are effective in reducing pain and opioid consumption postsurgery. Liposomal bupivacaine (LB), shown effective in shoulder surgery, was approved in November 2023 for use in US-guided lower extremity blocks.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
September 2025
UPMC Sports Surgery Clinic, Santry Demesne, Dublin, Ireland.
Purpose: Bone-patellar tendon-bone (BPTB) and Hamstring (HT) autografts are commonly used for anterior cruciate ligament reconstruction (ACLR). Concerns exist regarding postoperative anterior knee pain (AKP) and kneeling discomfort with BPTB grafts. However, many studies solely report the presence/absence of anterior knee pain, without assessing its clinical significance in terms of functional limitation or impact on quality of life.
View Article and Find Full Text PDFJ Pain Palliat Care Pharmacother
September 2025
Spine Unit, Orthopaedic Surgery and Traumatology Department, Catholic University and Polytechnic Hospital, Valencia, Spain.
Dexmedetomidine (DEX) has been proposed as an opioid-sparing adjunct after spinal fusion, but its efficacy across age groups is unclear. We conducted a systematic review and meta-analysis following PRISMA and registered in International Prospective Register of Systematic Reviews (PROSPERO) (CRD42024531252). Twelve studies (RCTs and cohorts; n=1,644) were included.
View Article and Find Full Text PDFCancer
September 2025
Department of Biostatistics, Brown University School of Public Health, Providence, Rhode Island, USA.
Background: Opioid exposure during cancer therapy may increase long-term unsafe opioid prescribing. This study sought to determine the rates of coprescription of benzodiazepine and opioid medications and new persistent opioid use after surgical treatment of early-stage cancer.
Methods: A retrospective cohort study was conducted among a US veteran population via the Veterans Affairs Corporate Data Warehouse database.
Nan Fang Yi Ke Da Xue Xue Bao
August 2025
Guangzhou Twelfth People's Hospital, Guangzhou 510700, China.
Objectives: To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application. Methods and.
Results: Recommendations were formulated based on literature review and expert group discussion, and consensus was reached following expert consultation.