Abstract
AimsIt is perceived that patients with a history of frequent alcohol consumption require more opioids for postoperative pain control and experience less postoperative nausea and vomiting than patients without such a history. However, there is scarce evidence supporting this notion. The aim of this study was to assess association between frequent alcohol consumption and opioid requirement for postoperative pain control and occurrence of postoperative nausea and vomiting.MethodsThe medical records for 4143 patients using intravenous patient-control analgesia with opioids after abdominal surgery between January 2010 and September 2013 were obtained, and associations were sought between the cumulative opioid consumption (in intravenous morphine equivalence) per body weight (mg/kg) in the first 2 days after abdominal operation and several demographic and clinical variables by multiple regression analysis. The association between the occurrence of postoperative nausea and vomiting and several demographic and clinical variables was also sought by multiple logistic regression analysis.ResultsFrequent alcohol drinking, among other previously reported factors, was associated with increased opioid consumption for postoperative pain control (p < 0.001). The estimate effect of frequent alcohol drinking was 0.117 mg/kg. Frequent alcohol drinking was also associated with decreased risks of postoperative nausea (odds ratio = 0.59, p = 0.003) and vomiting (odds ratio = 0.49, p = 0.026).ConclusionsFrequent alcohol drinking was associated with increased opioid consumption for postoperative pain control and decreased risks of postoperative nausea and vomiting after abdominal surgery.
Highlights
Postoperative pain management is a clinical challenge
Frequent alcohol drinking was associated with decreased risks of postoperative nausea and vomiting
Frequent alcohol drinking was associated with increased opioid consumption for postoperative pain control and decreased risks of postoperative nausea and vomiting after abdominal surgery
Summary
Postoperative pain management is a clinical challenge. Inadequate pain relief after operation is associated with decreased patient satisfaction [1], delayed hospital discharge [2], adverse functional outcome [3], and increased morbidity and mortality [4]. Knowledge regarding predicting factors of postoperative opioid requirement and of occurrence of opioid-related side effects such as PONV could be helpful in formulating an effective pain control program with minimized side effects for individual patient. Previous studies have examined numerous potential factors and identified age, types of surgery, pre-existing psychological distress, ethnicity, and genetic polymorphisms as predictors of opioid requirement after operation [5,6,7,8,9]. Early studies have examined numerous potential factors and identified age, gender, current smoking status, history of motion sickness or PONV, using volatile anesthetics and postoperative opioids as predictors of PONV [11,12,13,14], but there is only limited evaluation on the impact of alcohol consumption on the occurrence of PONV [10]
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