Nimmaanrat Sasikaan, Thongkumdee Withaporn, Geater Alan F, Oofuvong Maliwan, Benjhawaleemas Pannawit
Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand.
Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand.
J Pain Res. 2021 Nov 23;14:3585-3592. doi: 10.2147/JPR.S327230. eCollection 2021.
Cesarean section is the most common major surgery performed globally. Blood group O has been found as a factor affecting pain severity after cesarean section. We aimed to evaluate the predictive factors, including ABO blood group, for the amount of opioid consumption (measured as milligrams of morphine equivalent [MME]) within the first 24 hrs after cesarean section.
This retrospective study was done in 1530 pregnant women who had a cesarean section under the same regimen of spinal anesthesia (2.2 mL of 0.5% hyperbaric bupivacaine and morphine 0.2 mg). All were prescribed regular paracetamol and ibuprofen for postoperative pain control. Univariate and multinomial regression analyses were performed to identify the predictive factors for opioid consumption in the first 24 hrs postoperatively.
About 2/5 of them (43.3%) received 0 mg MME, while 25.6%, 23.7% and 7.4% received 1-5, 6-10 and >10 mg MME, respectively. The majority have blood group O (40.6%), while 23.4%, 28% and 8% have blood group A, B and AB, respectively. After univariate and multinomial regression analyses, operation time, opioid consumption in PACU, maximum VNRS within the first 24 hrs and consumption of both paracetamol and ibuprofen were identified as predictive factors for postoperative opioid consumption. ABO blood group exhibited no correlation for opioid requirement postoperatively.
ABO blood group is not a predictive factor for opioid requirement within the first 24 hrs following cesarean section. Duration of operation, opioid given in PACU, maximum VNRS on ward and consumption of both paracetamol and ibuprofen have been found to be predictive factors for postcesarean opioid requirement.
剖宫产是全球最常见的大型手术。已发现O型血是影响剖宫产后疼痛严重程度的一个因素。我们旨在评估剖宫产术后24小时内阿片类药物消耗量（以吗啡当量毫克[MME]衡量）的预测因素，包括ABO血型。
本回顾性研究纳入了1530例接受相同脊麻方案（2.2 mL 0.5%高压布比卡因和0.2 mg吗啡）剖宫产的孕妇。所有患者均常规使用对乙酰氨基酚和布洛芬进行术后疼痛控制。进行单因素和多项回归分析以确定术后24小时内阿片类药物消耗量的预测因素。
约五分之二（43.3%）的患者MME用量为0 mg，而分别有25.6%、23.7%和7.4%的患者MME用量为1 - 5 mg、6 - 10 mg和>10 mg。大多数患者为O型血（40.6%），而分别有23.4%、28%和8%的患者为A型、B型和AB型血。经过单因素和多项回归分析，手术时间、麻醉后恢复室（PACU）的阿片类药物消耗量、术后24小时内的最大视觉模拟评分（VNRS）以及对乙酰氨基酚和布洛芬的联合使用量被确定为术后阿片类药物消耗量的预测因素。ABO血型与术后阿片类药物需求量无相关性。
ABO血型不是剖宫产术后24小时内阿片类药物需求量的预测因素。已发现手术时间、PACU给予的阿片类药物、病房的最大VNRS以及对乙酰氨基酚和布洛芬的联合使用量是剖宫产后阿片类药物需求量的预测因素。
