Influence of non-opiate analgesia on postoperative pain intensity and patient satisfaction

Objective. To compare the results of postoperative opiate and non-opiate analgesia. Material and Methods. The study was carried out as a part of the OPERAS global trial. Analysis was conducted in accordance with the STROBE reporting guidelines for observational studies. A prospective cohort study included data of patients after emergency and elective abdominal surgery. Primary outcomes were duration of severe pain and patient satisfaction with pain relief during the first week after surgery. Data were collected through review of case reports and interviews with patients one week after surgery. Results. The study involved 173 postoperative patients. Opioid analgesia after surgery was prescribed in 52 patients (30.1 %); 10% of patients reported severe pain within the first week after surgery and rated satisfaction with analgesia as 90 out of 100 points. After adjusting for confounders, opiate analgesia was independently associated with higher pain (hazard ratio 1.52, 95% CI 1.31 to 1.76; p<0.001) and need for medical care for drug-related side effects (OR 2.38, 95% CI 1.36 to 4.17; p=0.004). Opiate analgesia was not associated with satisfaction with analgesia (β coefficient 0.92, 95% CI –1.52 to 3.36; p=0.468) compared to non-opiate analgesia. Conclusion. Postoperative opiate analgesia is associated with higher risk of drug-related side effects and aggravation of pain, but not with changes in satisfaction with pain relief. Non-opiate analgesia should be used regularly after surgery.