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Impact of opoids and paracetamol after liver resection for colorectal cancer metastasis

Östrand, Emil LU ; Bergfelt, Maja ; Lundmark Rystedt, Jenny LU ; Andersson, Bodil LU orcid and Tingstedt, Bobby LU (2023) In Archives of Clinical and Medical Case Reports 7(3). p.261-268
Abstract
Background: Altered metabolism after liver surgery adds complexity to
postoperative pain management. Opioids administered via intravenous
Patient Controlled Analgesia (PCA) is one of the main alternatives for
initial pain management. Paracetamol is considered potentially dangerous
after liver surgery but used selectively. This study evaluates whether there
is a difference in patient outcome after hepatic resection, based on the
amounts of opioids used in the first postoperative period, and on the use of
postoperative paracetamol.
Methods: 208 consecutive patients with hepatic resection for colorectal
liver metastasis in Lund, Sweden, were included. Opioids consumed within
the first 24 hours... (More)
Background: Altered metabolism after liver surgery adds complexity to
postoperative pain management. Opioids administered via intravenous
Patient Controlled Analgesia (PCA) is one of the main alternatives for
initial pain management. Paracetamol is considered potentially dangerous
after liver surgery but used selectively. This study evaluates whether there
is a difference in patient outcome after hepatic resection, based on the
amounts of opioids used in the first postoperative period, and on the use of
postoperative paracetamol.
Methods: 208 consecutive patients with hepatic resection for colorectal
liver metastasis in Lund, Sweden, were included. Opioids consumed within
the first 24 hours postoperatively were summed up. The use of paracetamol
in the first four days was recorded. The effect of opioid consumption was
analysed by grouping patients into those consuming higher amounts of
opioids than the median (HO) and those consuming less amounts (LO).
Patient outcome was evaluated by length-of-stay (LOS) and postoperative
complications.
Results: The HO-group had a longer LOS than the LO-group, by a
regression coefficient of 1.19, p=0.001, after adjusting for confounders.
Use of paracetamol individually shortened the LOS, by 0.83, p=0.002.
There was no impact of these factors on postoperative complications.
Conclusion: Larger consumption of opioids in the first postoperative day
negatively impacts the LOS. Paracetamol shortens the LOS and should be
considered after hepatic surgery. (Less)
Please use this url to cite or link to this publication:
author
; ; ; and
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publishing date
type
Contribution to journal
publication status
published
subject
in
Archives of Clinical and Medical Case Reports
volume
7
issue
3
pages
261 - 268
DOI
10.26502/acmcr.96550609
language
English
LU publication?
yes
id
469a1337-d067-4be6-8e35-6635afd4d4d9
date added to LUP
2024-10-01 12:07:15
date last changed
2024-10-02 07:57:11
@article{469a1337-d067-4be6-8e35-6635afd4d4d9,
  abstract     = {{Background: Altered metabolism after liver surgery adds complexity to<br/>postoperative pain management. Opioids administered via intravenous<br/>Patient Controlled Analgesia (PCA) is one of the main alternatives for<br/>initial pain management. Paracetamol is considered potentially dangerous<br/>after liver surgery but used selectively. This study evaluates whether there<br/>is a difference in patient outcome after hepatic resection, based on the<br/>amounts of opioids used in the first postoperative period, and on the use of<br/>postoperative paracetamol.<br/>Methods: 208 consecutive patients with hepatic resection for colorectal<br/>liver metastasis in Lund, Sweden, were included. Opioids consumed within<br/>the first 24 hours postoperatively were summed up. The use of paracetamol<br/>in the first four days was recorded. The effect of opioid consumption was<br/>analysed by grouping patients into those consuming higher amounts of<br/>opioids than the median (HO) and those consuming less amounts (LO).<br/>Patient outcome was evaluated by length-of-stay (LOS) and postoperative<br/>complications.<br/>Results: The HO-group had a longer LOS than the LO-group, by a<br/>regression coefficient of 1.19, p=0.001, after adjusting for confounders.<br/>Use of paracetamol individually shortened the LOS, by 0.83, p=0.002.<br/>There was no impact of these factors on postoperative complications.<br/>Conclusion: Larger consumption of opioids in the first postoperative day<br/>negatively impacts the LOS. Paracetamol shortens the LOS and should be<br/>considered after hepatic surgery.}},
  author       = {{Östrand, Emil and Bergfelt, Maja and Lundmark Rystedt, Jenny and Andersson, Bodil and Tingstedt, Bobby}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{261--268}},
  series       = {{Archives of Clinical and Medical Case Reports}},
  title        = {{Impact of opoids and paracetamol after liver resection for colorectal cancer metastasis}},
  url          = {{http://dx.doi.org/10.26502/acmcr.96550609}},
  doi          = {{10.26502/acmcr.96550609}},
  volume       = {{7}},
  year         = {{2023}},
}