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21KF-052
Factors associated with rebound pain after postoperative epidural analgesia for abdominal surgery: a retrospective study
Hyun-Jung Kwon, Jong-Hyuk Lee, Yeon Ju Kim, Sung-Moon Jeong, Doo-Hwan Kim
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea
Introduction: Although epidural patient-controlled analgesia (PCA) is an effective regional analgesia for abdominal surgery, the authors experienced that some patients complained of significant rebound pain after removal of epidural PCA. To our knowledge, there have been no studies investigating factors associated with rebound pain in epidural PCA. Therefore, this study is aimed to evaluate the incidence and explore potential risk factors for rebound pain related to epidural PCA.
Material and Methods: From 2018 to 2020, we performed a retrospective review of 236 patients who underwent hepatobiliary and pancreas surgery using epidural PCA in a tertiary hospital in South Korea. Rebound pain was defined as an increase from well-controlled pain (numeric rating scale<4) during epidural analgesia to severe pain (numeric rating scale≥7) within 24 hours after removal of epidural PCA. Logistic regression analysis was performed to determine the factors associated with rebound pain.
Results: Among the 236 patients included in the analysis, 170 (72%) and 66 (28%) patients were in the non-rebound pain and rebound pain group after removal of epidural PCA, respectively. Multivariable logistic regression analysis showed that transfusion (OR=4.190, 95% CI=1.436ndent factor associated with rebound pain after removal of epidural PCA. In contrast, prognostic nutritional index (PNI) < 45 (OR=0.481, 95% CI=0.245ciated with non-rebound pain after removal of epidural PCA.
Conclusion: Our findings suggest that transfusion and PNI < 45 may be independently associated with rebound pain after removal of epidural PCA in the patients who underwent open abdominal surgery.