Influential factors of postoperative pain trajectories in patients receiving intravenous patient-controlled analgesia: a single-centre cohort study in Taiwan

Abstract

Objectives We aimed to investigate the factors associated with variations in postoperative pain trajectories over time in patients using intravenous patient-controlled analgesia (IV-PCA) for postoperative pain.Design Retrospective cohort study.Setting A single medical centre in Taiwan.Participants Patients receiving IV-PCA after surgery.Primary and secondary outcome measures Primary outcome was the postoperative pain scores.Results A total of 3376 patients and 20 838 pain score observations were analysed using latent curve models. Female and longer anaesthesia time increased the baseline level of pain (p=0.004 and 0.003, respectively), but abdominal surgery and body weight decreased it (both p<0.001). Regarding the trend of pain resolution, lower abdominal surgery steepened the slope (p<0.001); older age, American Society of Anesthesiologists (ASA) class ≥3 and longer anaesthesia time tended to flatten the slope (p<0.001, =0.019 and <0.001, respectively). PCA settings did not affect the variations in postoperative pain trajectories.Conclusions Patient demographics, ASA class, anaesthesia time and surgical sites worked together to affect postoperative pain trajectories in patients receiving IV-PCA. Latent curve models provided valuable information about the dynamic and complex relationships between the pain trajectories and their influential factors.