Postoperative pain management in Chinese hospitals: a national survey

Wang, Yafeng; Yang, Dong; Zhao, Shuai; Han, Linlin; Xu, Feng; Huang, Shiqian; Yuan-yuan, Ding; Deng, Dalin; Mi, Weidong; Chen, Xiangdong

doi:10.1016/j.bja.2021.08.026

Cited by 10 publications

(19 citation statements)

References 6 publications

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“…A total of 2198 (44.0%) valid questionnaires from 29 municipalities, provinces and autonomous regions were included in this study as we reported previously [ 9 ], and the proportion of questionnaires submitted by each region is shown in Fig. 1 A.…”

Section: Resultsmentioning

confidence: 99%

“…Four thousand nine hundred ninety-six hospitals above Grade II from 31 provinces and municipalities across mainland China, which was representative of the situation in Chinese hospitals, were identified from the National Health Commission of the People’s Republic of China as we described previously [ 9 ]. Grade II hospitals are defined as centers that provide medical and health services across several communities and represent regional technical centers, while Grade III hospitals are defined as medical prevention technology centers with comprehensive medical, teaching and scientific research capacities [ 1 , 9 ].…”

Section: Methodsmentioning

confidence: 99%

“…Additionally, we collected information about the difficulties associated with procedural analgesic interventions. The questionnaire was subsequently distributed to the chief anesthesiologist or a member of the Pain Group of the Chinese Society of Anesthesiology in each identified hospital through WeChat (Tencent, Shenzhen, China) as we described previously [ 9 ]. In case of no response, second or third calls were performed.…”

Section: Methodsmentioning

confidence: 99%

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Procedural analgesic interventions in China: a national survey of 2198 hospitals

Wang

Xu²,

Zhao³

et al. 2022

BMC Anesthesiol

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Background Humane treatment requires the provision of appropriate sedation and analgesia during medical diagnosis and treatment. However, limited information is available about the status of procedural analgesic interventions in Chinese hospitals. Therefore, a nationwide survey was established to identify challenges and propose potential improvement strategies. Methods Forty-three members of the Pain Group of Chinese Society of Anesthesiology established and reviewed the questionnaire, which included (1) general information on the hospitals, (2) the sedation/analgesia rate in gastrointestinal endoscopy, labor, flexible bronchoscopy, hysteroscopy in China, (3) staff assignments, (4) drug use for procedural analgesic interventions, and (5) difficulties in procedural analgesic interventions. The data were obtained using an online questionnaire sent to the chief anesthesiologists of Chinese hospitals above Grade II or members of the Pain Group of Chinese Society of Anesthesiology. Results Valid and complete questionnaires were received from 2198 (44.0%) hospitals, of which 64.5% were Grade III. The overall sedation/analgesia rates were as follows: gastroscopy (50.6%), colonoscopy (53.7%), ERCP (65.9%), induced abortion (67.5%), labor (42.3%), hysteroscopy (67.0%) and fiber bronchoscopy (52.6%). Compared with Grade II hospitals, Grade III hospitals had a higher proportion of procedural analgesic interventions services except for induced abortion. On average (median [IQR]), each anesthesiologist performed 5.7 [2.3—11.4] cases per day, with 7.3 [3.2—13.6] performed in Grade III hospitals and 3.4 [1.8—6.8] performed in Grade II hospitals (z = -7.065, p < 0.001). Conclusions Chinese anesthesiologists have made great efforts to achieve procedural analgesic interventions, as evidenced by the increased rate. The uneven health care provided by hospitals at different levels and in different regions and the lack of anesthesiologists are the main barriers to optimal procedural analgesic interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Procedural analgesic interventions in China: a national survey of 2198 hospitals

Wang

Xu²,

Zhao³

et al. 2022

BMC Anesthesiol

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“…According to a recent national survey in Chinese hospitals, sufentanil ranked first in opioids used for PCA (>80% of hospitals) ( Wang et al, 2021 ). Due to the lack of a well-established standard, the choice of opioid and adjuvant in IV-PCA depends on anesthesiologist familiarity and drug accessibility, rather than evidence ( Grass, 2005 ; Fernandes et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

“…However, gastrointestinal adverse effects occur more frequently with FBP than with other NSAIDs, among which nausea is representative with an incidence of >3% ( Brogden et al, 1979 ; Drugs.com, 2022 ). Therefore, we hypothesized that hydromorphone might be a better choice and performed further evaluations of the effectiveness of FBP ( Wang et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

New insight into the analgesic recipe: A cohort study based on smart patient-controlled analgesia pumps records

Song

Huang

et al. 2022

Front. Pharmacol.

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Purpose: Intravenous patient-controlled analgesia (IV-PCA) has been widely used; however, regimen criteria have not yet been established. In China, the most often used opioid is sufentanil, for which repeated doses are a concern, and empirical flurbiprofen axetil (FBP) as an adjuvant. We hypothesized that hydromorphone would be a better choice and also evaluated the effectiveness of FBP as an adjuvant.Methods: This historical cohort study was conducted in two tertiary hospitals in China and included 12,674 patients using hydromorphone or sufentanil for IV-PCA between April 1, 2017, and January 30, 2021. The primary outcome was analgesic insufficiency at static (AIS). The secondary outcomes included analgesic insufficiency with movement (AIM) and common opioid-related adverse effects such as postoperative nausea and vomiting (PONV) and dizziness.Results: Sufentanil, but not the sufentanil-FBP combination, was associated with higher risks of AIS and AIM compared to those for hydromorphone (OR 1.64 [1.23, 2.19], p < 0.001 and OR 1.42 [1.16, 1.73], p < 0.001). Hydromorphone combined with FBP also decreased the risk of both AIS and AIM compared to those for pure hydromorphone (OR 0.74 [0.61, 0.90], p = 0.003 and OR 0.80 [0.71, 0.91], p < 0.001). However, the risk of PONV was higher in patients aged ≤35 years using FBP (hydromorphone-FBP vs. hydromorphone and sufentanil-FBP vs. hydromorphone, OR 1.69 [1.22, 2.33], p = 0.001 and 1.79 [1.12, 2.86], p = 0.015).Conclusion: Hydromorphone was superior to sufentanil for IV-PCA in postoperative analgesia. Adding FBP may improve the analgesic effects of both hydromorphone and sufentanil but was associated with an increased risk of PONV in patients <35 years of age.

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Response: Assessing effect of local block on quality of recovery following cesarean delivery under general anesthesia

Tao,

Ning,

et al. 2023

Intl J Gynecology & Obste

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Postoperative pain management in Chinese hospitals: a national survey

Cited by 10 publications

References 6 publications

Procedural analgesic interventions in China: a national survey of 2198 hospitals

Procedural analgesic interventions in China: a national survey of 2198 hospitals

New insight into the analgesic recipe: A cohort study based on smart patient-controlled analgesia pumps records

Response: Assessing effect of local block on quality of recovery following cesarean delivery under general anesthesia

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