Sex Differences in Elderly Patients Using Patient Controlled Analgesia in the Postoperative Period: A Retrospective Database Analysis

Abstract

Background: Sex differences in pain perception exist in humans. This study aimed to search whether sex differences also existed in patient controlled analgesia (PCA) among elderly populations. Methods: Patients’ information was retrieved from a quality-insurance database from a period of 2 years. Demographic characters, types of PCA mode, consumptions of PCA drugs on postoperative Day 1, all PCA-related complications, visual analogue scale in bed rest, daily activities, and coughing, surgical sites, American Society of Anesthesiologists physical status, and satisfaction to PCA were all analyzed. Results: A total of 1441 women (71.6±8.4 years) and 730 men (70.9±7.7 years) were analyzed. Elderly women had higher incidences of nausea, vomiting, vertigo, inappropriate sensory and motor blockages, as well experiencing more pain in bed rest and daily activities. Elderly men had more pain experience while coughing but had higher satisfactions to PCA. Conclusion: Several important sex differences existed in the elderly patients when utilizing PCA as pain management. More concern should be drawn to these differences to minimize PCA-related complications and to avoid the potential hazard of PCA in vulnerable elderly patients. Generalization of this application in other constitutions requires further studies.

Keywords

• epidural analgesia
• geriatric surgery
• opioid complications
• postoperative care
• sexual differences