Analgesic Consumption in the Early Postoperative Period: A Prospective Observational PACU Study

Официальное название

Factors Influencing Analgesic Consumption in the Early Postoperative Period: A Prospective Observational Study in the Post-Anesthesia Care Unit

Обзор

Postoperative pain remains a significant clinical challenge that directly affects patient recovery, functional outcomes, and overall quality of care. Inadequate pain control in the early postoperative period is associated with delayed mobilization, increased risk of complications, prolonged hospital stay, and the development of chronic pain. The post-anesthesia care unit (PACU) represents a critical phase in which pain is actively assessed and managed, and analgesic consumption during this period serves as an objective indicator of analgesic requirements and effectiveness of perioperative pain strategies. This prospective observational study aims to identify patient-related, surgical, and anesthesia-related factors influencing analgesic consumption in the early postoperative period among adult patients admitted to the PACU following elective surgery. No additional interventions will be performed, and all perioperative management will follow routine clinical practice. Data will be collected prospectively from clinical records, anesthesia charts, and PACU monitoring forms. The primary outcome is total analgesic consumption during the PACU stay. Secondary outcomes include pain intensity assessed using a standardized pain scale at PACU admission and discharge, requirement for rescue analgesia, incidence of postoperative nausea and vomiting, and length of stay in the PACU. The findings of this study are expected to contribute to the identification of patients at higher risk for increased analgesic requirements and to support the development of individualized pain management strategies, ultimately improving perioperative care quality and patient outcomes.

Подробное описание

Postoperative pain is a major clinical concern that significantly affects recovery, patient satisfaction, and overall perioperative outcomes. Inadequate pain control in the early postoperative period is associated with delayed mobilization, increased risk of complications, prolonged hospital stay, and the development of chronic postoperative pain. Therefore, early identification of factors influencing analgesic requirements is essential for optimizing individualized pain management strategies.

The post-anesthesia care unit (PACU) represents a critical period during which patients are closely monitored following surgery, and pain management is actively adjusted. Analgesic consumption during this phase provides an objective and clinically relevant measure of pain management adequacy. However, analgesic requirements may vary widely depending on patient-related factors (such as age, sex, and body mass index), surgical characteristics (type and duration of surgery), and anesthesia-related variables (anesthetic technique, intraoperative analgesic administration, and use of regional anesthesia).

This study is designed as a single-center, prospective observational study conducted in the post-anesthesia care unit of a tertiary oncology hospital. Adult patients undergoing elective surgical procedures will be included. No additional interventions will be performed, and all perioperative care will be administered according to routine clinical practice. Data will be collected prospectively from anesthesia records, PACU monitoring forms, and hospital electronic systems.

The primary outcome is total analgesic consumption during the PACU stay. Secondary outcomes include pain intensity at PACU admission and discharge, requirement for rescue analgesia, incidence of postoperative nausea and vomiting, and length of stay in the PACU.

The findings of this study are expected to contribute to the identification of patients at higher risk for increased analgesic requirements in the early postoperative period. These results may support the development of individualized and more effective pain management strategies and improve overall perioperative care quality.

Вмешательства

• Другое Observational Assessment
  This is a non-interventional observational study. No experimental intervention is applied. All patients receive routine perioperative care according to institutional clinical practice. The study involves prospective collection and analysis of clinical data related to analgesic consumption and associated factors during the early postoperative period in the post-anesthesia care unit (PACU).

Первичные конечные точки

• Total Analgesic Consumption in the PACU [Срок оценки: During PACU stay (from admission to discharge, within approximately 0-4 hours postoperatively)]

Вторичные конечные точки (5)

• Pain Intensity at PACU Admission [Срок оценки: At PACU admission (within the immediate postoperative period)]
• Pain Intensity at PACU Discharge [Срок оценки: At PACU discharge (within approximately 0-4 hours postoperatively)]
• Requirement for Rescue Analgesia in the PACU [Срок оценки: During PACU stay (from admission to discharge, within approximately 0-4 hours postoperatively)]
• Incidence of Postoperative Nausea and Vomiting in the PACU [Срок оценки: During PACU stay (from admission to discharge, within approximately 0-4 hours postoperatively)]
• Length of Stay in the PACU [Срок оценки: During PACU stay (from admission to discharge, within approximately 0-4 hours postoperatively)]

Критерии участия

Критерии включения

• Adults aged 18 years and older
• Undergoing elective surgical procedures
• Admitted to the post-anesthesia care unit (PACU) after surgery
• Receiving general and/or regional anesthesia
• Able to provide informed consent

Критерии исключения

• Patients younger than 18 years
• Emergency surgical procedures
• Patients transferred directly to the intensive care unit postoperatively
• PACU stay shorter than 30 minutes
• Patients unable to communicate or assess pain
• Incomplete clinical records
• Refusal to participate in the study

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения

Когортное

Центры проведения

Turkey (Türkiye) · 1 центр

• Dr. Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital Clinic of Anesth — Ankara

Публикации

• Kehlet H, Dahl JB. Anaesthesia, surgery, and challenges in postoperative recovery. Lancet. 2003 Dec 6;362(9399):1921-8. doi: 10.1016/S0140-6736(03)14966-5. PMID 14667752
• Gan TJ, Diemunsch P, Habib AS, Kovac A, Kranke P, Meyer TA, Watcha M, Chung F, Angus S, Apfel CC, Bergese SD, Candiotti KA, Chan MT, Davis PJ, Hooper VD, Lagoo-Deenadayalan S, Myles P, Nezat G, Philip BK, Tramer MR; Society for Ambulatory Anesthesia. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2014 Jan;118(1):85-113. doi: 10.1213/ANE.0000000000000002 PMID 24356162
• Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003 Aug;97(2):534-540. doi: 10.1213/01.ANE.0000068822.10113.9E. PMID 12873949

Идентификаторы

NCT: NCT07547618 · 2026-04/75

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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