Influences of Gender on Postoperative Morphine Consumption

Periasamy, Sivakumar; Poovathai, Raja; Pondiyadanar, Srinivasan

doi:10.7860/jcdr/2014/10770.5319

Cited by 13 publications

(12 citation statements)

References 22 publications

(17 reference statements)

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“…Other studies have found that patients with higher socioeconomic status (measured in education level), female gender, mood disorders and those taking sedating medications have an increased risk of opioid OD outside the hospital 15, 16 . Interestingly, Periasamy et al found that male gender was associated with significantly higher consumption of morphine after abdominal operations 17 , which contrasts our findings that men are at lower risk of postoperative OD. Perhaps the risk of postoperative OD in these subgroups is due to use of standard dosing for all patients, not considering medication interactions or difference in weight that might be present.…”

Section: Discussioncontrasting

confidence: 99%

Predictors of In-hospital Postoperative Opioid Overdose After Major Elective Operations

et al. 2017

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Objective: To describe national trends and outcomes of in-hospital postoperative opioid overdose (OD) and identify predictors of postoperative OD. Summary Background Data: In 2000 the Joint Commission recommended making pain the 5th vital sign, increasing the focus on postoperative pain control. However, the benefits of pain management must be weighed against the potentially lethal risk of opioid OD. Methods: This is a retrospective multi-institutional cohort study of patients undergoing one of six major elective inpatient operation from 2002 to 2011 using the Nationwide Inpatient Sample, an approximately 20% representative sample of all United States hospital admissions. Patients with postoperative OD were identified using ICD-9 codes for poisoning from opioids or adverse effects from opioids. Multivariate logistic regression was used to identify independent predictors. Results: Among 11,317,958 patients, 9,458 (0.1%) had a postoperative OD; this frequency doubled over the study period from 0.6 to 1.1 overdoses per 1,000 cases. Patients with postoperative OD died more frequently during their hospitalization (1.7% vs. 0.4%, p-value < 0.001). Substance abuse history was the strongest predictor of OD (OR=14.8; 95% CI: 12.7–17.2). Gender, age, income, geographic location, operation type, and certain comorbid diseases also predicted OD (p<0.05). Hospital variables including teaching status, size, and urban/rural location did not predict postoperative OD. Conclusions: Postoperative OD is a rare, but potentially lethal complication, with increasing incidence. Postoperative monitoring and treatment safety interventions should be thoughtfully employed to target high risk patients and avoid this potentially fatal complication.

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Section: Discussioncontrasting

confidence: 99%

Predictors of In-hospital Postoperative Opioid Overdose After Major Elective Operations

et al. 2017

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“…In a large recent study investigating visceral postoperative pain after elective abdominal surgery including 450 patients, men required significantly more morphine than women in the first 24 h after surgery (34.4 AE 6.7 vs. 26.8 AE 7.1 mg, P < 0.001) [11]. However, these doses are not weight-based; furthermore, women scored higher pain ratings in this study indicating not a gender difference in pain per se but in analgesic requests with women getting less opioids, and therefore experiencing more pain than men.…”

Section: Visceral and Thoracic Surgerymentioning

confidence: 92%

Gender aspects in postoperative pain

Pereira

Pogatzki-Zahn

2015

Current Opinion in Anaesthesiology

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“…In adults, current evidence suggests that several factors may influence analgesic response during the course of the illness [ 7 ]. For example, it has been reported that men require more morphine in the postoperative period than women [ 8 ] and obesity may partly explain inter-individual variations in opioid efficacy and toxicity [ 9 ]. Moreover, it is fundamental to consider the influence of genetic factors regulating opioid pharmacokinetics (e.g.…”

Section: Introductionmentioning

confidence: 99%

A systematic review of the risk factors for clinical response to opioids for all-age patients with cancer-related pain and presentation of the paediatric STOP pain study

et al. 2018

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BackgroundInter-patient variability in response to opioids is well known but a comprehensive definition of its pathophysiological mechanism is still lacking and, more importantly, no studies have focused on children. The STOP Pain project aimed to evaluate the risk factors that contribute to clinical response and adverse drug reactions to opioids by means of a systematic review and a clinical investigation on paediatric oncological patients.MethodsWe conducted a systematic literature search in EMBASE and PubMed up to the 24th of November 2016 following Cochrane Handbook and PRISMA guidelines. Two independent reviewers screened titles and abstracts along with full-text papers; disagreements were resolved by discussion with two other independent reviewers. We used a data extraction form to provide details of the included studies, and conducted quality assessment using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.ResultsYoung age, lung or gastrointestinal cancer, neuropathic or breakthrough pain and anxiety or sleep disturbance were associated to a worse response to opioid analgesia. No clear association was identified in literature regarding gender, ethnicity, weight, presence of metastases, biochemical or hematological factors. Studies in children were lacking. Between June 2011 and April 2014, the Italian STOP Pain project enrolled 87 paediatric cancer patients under treatment with opioids (morphine, codeine, oxycodone, fentanyl and tramadol).ConclusionsFuture studies on cancer pain should be designed with consideration for the highlighted factors to enhance our understanding of opioid non-response and safety. Studies in children are mandatory.Trial registrationCRD42017057740.Electronic supplementary materialThe online version of this article (10.1186/s12885-018-4478-3) contains supplementary material, which is available to authorized users.

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Influences of Gender on Postoperative Morphine Consumption

Cited by 13 publications

References 22 publications

Predictors of In-hospital Postoperative Opioid Overdose After Major Elective Operations

Predictors of In-hospital Postoperative Opioid Overdose After Major Elective Operations

Gender aspects in postoperative pain

A systematic review of the risk factors for clinical response to opioids for all-age patients with cancer-related pain and presentation of the paediatric STOP pain study

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