Postoperative pain management after concomitant sacrectomy for locally recurrent rectal cancer,Surgery Today

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Postoperative pain management after concomitant sacrectomy for locally recurrent rectal cancer
Surgery Today ( IF 1.7 ) Pub Date : 2022-06-04 , DOI: 10.1007/s00595-022-02522-7
Masatoshi Kitakaze ₁ , Mamoru Uemura ₁ , Yuta Kobayashi ₁ , Masakatsu Paku ₁ , Masaaki Miyo ₂ , Yusuke Takahashi ₂ , Masakazu Miyake ₂ , Takeshi Kato ₂ , Masataka Ikeda ₃ , Shiki Fujino ₁ , Takayuki Ogino ₁ , Norikatsu Miyoshi ₁ , Hidekazu Takahashi ₁ , Hirofumi Yamamoto ₁ , Tsunekazu Mizushima ₁ , Mitsugu Sekimoto ₄ , Yuichiro Doki ₁ , Hidetoshi Eguchi ₁

Affiliation

Purpose

To assess pain management in patients post-sacrectomy, focusing on opioid use, and to identify the factors associated with postoperative pain.

Methods

Patients who underwent resection of locally recurrent rectal cancer (LRRC) with concomitant sacrectomy at one of two hospitals between 2007 and 2020 were reviewed retrospectively. We examined the use of opioids preoperatively and postoperatively. Patients were classified into high and low sacrectomy groups based on the sacral bone resection level passing through the S3 vertebra.

Results

Sixty-four patients were enrolled. Opioid use was significantly higher in the high sacrectomy group than in the low sacrectomy group at all times assessed: on postoperative days 7, 14, 30, 90, 180, and 365. Opioid use 3 months after locally recurrent rectal cancer surgery was significantly higher in patients with local re-recurrence of the tumor than in those without re-recurrence (p < 0.05), and the median morphine-equivalent opioid use 3 months postoperatively was significantly higher in the high sacrectomy group (30 vs. 0 mg/day; p < 0.05).

Conclusions

Opioid use after concomitant sacrectomy for LRRC was higher in the high sacrectomy group. Prolonged postoperative pain or increasing pain was associated with local recurrence.

中文翻译：

局部复发性直肠癌伴骶骨切除术后的术后疼痛管理

目的

评估骶骨切除术后患者的疼痛管理，重点关注阿片类药物的使用，并确定与术后疼痛相关的因素。

方法

回顾性回顾了 2007 年至 2020 年间在两家医院之一接受局部复发性直肠癌 (LRRC) 切除术并伴有骶骨切除术的患者。我们检查了术前和术后阿片类药物的使用情况。根据穿过S3椎骨的骶骨切除水平将患者分为高位和低位骶骨切除组。

结果

共招募了 64 名患者。术后第 7、14、30、90、180 和 365 天，高位骶骨切除术组的阿片类药物使用率显着高于低位骶骨切除术组。局部复发直肠癌手术后 3 个月的阿片类药物使用率显着更高在肿瘤局部复发的患者中，与没有复发的患者相比（p < 0.05），高位骶骨切除术组术后 3 个月的吗啡等效阿片类药物使用中位数显着更高（30 对 0 毫克/天） ; p < 0.05)。