Chang Kuang-Yi, Tsou Mei-Yung, Chan Kwok-Hon, Sung Chun-Sung, Chang Wen-Kuei
Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan.
J Formos Med Assoc. 2006 Nov;105(11):918-25. doi: 10.1016/S0929-6646(09)60177-7.
BACKGROUND/PURPOSE: Intravenous patient-controlled analgesia (IVPCA) is one of the most widely used postoperative analgesic methods. Many factors could affect the total analgesic consumption of IVPCA. This retrospective study investigated the relationship between patient characteristics and total morphine consumption during a 3-day course of postoperative IVPCA.
Patients receiving surgery under general anesthesia with postoperative IVPCA for 3 days during the period between January 2002 and December 2003 were included. Patient data including age, sex, weight, height, body mass index (BMI), operation type and site were collected. Total morphine consumption was recorded at the end of the 3-day IVPCA course. Stepwise regression analyses were conducted to select factors significantly associated with morphine consumption. Stratified analyses were also conducted among different surgical, BMI and age subgroups.
A total of 1308 patients (646 men, 662 women) were included in the analysis. For all operations, weight, age, procedures involving malignant disease, and surgical sites were significantly associated with total morphine consumption. The R and adjusted R2 values of the selected model were 0.509 and 0.256, respectively. Weight was the only common factor among all stratified analyses (all p < 0.001). Age was negatively correlated with morphine consumption. Gender was not a significant factor except in lower abdominal operations. Height was not associated with total morphine consumption. BMI status was not significantly associated with components of the selected factors.
This study demonstrated that weight and surgical sites significantly influence total IVPCA requirements. The effect of surgical sites should be considered when evaluating the influence of demographic characteristics on IVPCA demand.
背景/目的：静脉自控镇痛（IVPCA）是术后最广泛使用的镇痛方法之一。许多因素会影响IVPCA的总镇痛药物消耗量。本回顾性研究调查了患者特征与术后3天IVPCA疗程中吗啡总消耗量之间的关系。
纳入2002年1月至2003年12月期间接受全身麻醉手术且术后接受3天IVPCA的患者。收集患者的年龄、性别、体重、身高、体重指数（BMI）、手术类型和部位等数据。在3天IVPCA疗程结束时记录吗啡总消耗量。进行逐步回归分析以选择与吗啡消耗量显著相关的因素。还在不同手术、BMI和年龄亚组中进行了分层分析。
共有1308例患者（646例男性，662例女性）纳入分析。对于所有手术，体重、年龄、涉及恶性疾病的手术以及手术部位与吗啡总消耗量显著相关。所选模型的R值和调整后的R²值分别为0.509和0.256。体重是所有分层分析中唯一的共同因素（所有p<0.001）。年龄与吗啡消耗量呈负相关。除下腹部手术外，性别不是显著因素。身高与吗啡总消耗量无关。BMI状态与所选因素的组成部分无显著关联。
本研究表明体重和手术部位显著影响IVPCA的总需求量。在评估人口统计学特征对IVPCA需求的影响时应考虑手术部位的影响。
