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To predict sufentanil requirement for postoperative pain control using a real-time method: A prospective observational cohort study.

Abstract：

:Preoperative identification of individual sensitivity to opioid analgesics could improve the quality of postoperative analgesia. We explored the feasibility and utility of a real-time assessment of sufentanil sensitivity in predicting postoperative analgesic requirement.Our primary study included 111 patients who underwent measurements of pressure and quantitative pricking pain thresholds before and 5 minutes after sufentanil infusion. Pain intensity was assessed during the first 24-hour postsurgery, and patients who reported inadequate levels of analgesia were excluded from the study. The sufentanil requirement for patient-controlled analgesia was recorded, and a subsequent exploratory study of 20 patients facilitated the interpretation of the primary study results. In the primary study, experimental pain thresholds increased (P < 0.001) 5 minutes after sufentanil infusion, and the percent change in pricking pain threshold was positively associated with sufentanil requirement at 12 and 24 hours after surgery (β = 0.318, P = 0.001; and β = 0.335, P = 0.001). A receiver-operating characteristic curve analysis showed that patients with a change in pricking pain threshold >188% were >50% likely to require more sufentanil for postoperative pain control. In the exploratory study, experimental pain thresholds significantly decreased after the operation (P < 0.001), and we observed a positive correlation (P < 0.001) between the percent change in pricking pain threshold before and after surgery. Preoperative detection of individual sensitivity to sufentanil via the above described real-time method was effective in predicting postoperative sufentanil requirement. Thus, percent change in pricking pain threshold might be a feasible predictive marker of postoperative analgesia requirement.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Zhang Y,Duan G,Guo S,Ying Y,Huang P,Zhang M,Li N,Zhang X

doi

10.1097/MD.0000000000003915

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

e3915

issue

eissn

0025-7974

issn

1536-5964

pii

00005792-201606210-00023

journal_volume

pub_type

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To predict sufentanil requirement for postoperative pain control using a real-time method: A prospective observational cohort study.