Shanshan Wu, Shuren Wang, Zongwang Zhang
Department of Anesthesiology, Liaocheng People's Hospital, Shandong University, Liaocheng, China.
Department of Anesthesiology, Liaocheng People's Hospital, Liaocheng, China.
Ann Med. 2025 Dec;57(1):2499698. doi: 10.1080/07853890.2025.2499698. Epub 2025 May 10.
This study aimed to investigate the frequency of analgesic administration within 48 h after endoscopic submucosal dissection (ESD) or its derivative techniques across different segments of the digestive tract, as well as the timing of the initial analgesic administration.
This retrospective observational study was built upon previous research. The primary outcomes assessed were the time to initial analgesic administration postoperatively and the frequency of analgesic use within 48 h after ESD surgery. Additionally, factors influencing painkiller administration in ESD patients were analyzed.
Of the 2162 patients included in the study, 570 (26.36%) required postoperative analgesic medications. Most patients required their initial analgesic within 8 h following ESD, with the highest demand observed within 2 h. Multivariate Cox regression analysis indicated that intraoperative administration of ketorolac reduced the likelihood of analgesic administration within 2 h postoperatively (hazard ratio [HR] = 0.35, 95% confidence interval [CI]: 0.15-0.79, = 0.012). The time to first analgesic administration did not differ significantly among patients with varying surgical sites ( = 2.043, = 0.843) or surgical methods ( = 8.647, = 0.071). Similarly, no significant difference was observed in the frequency of analgesic use within 48 h across different surgical sites ( = 3.817, = 0.576). However, patients who underwent endoscopic submucosal excavation (ESE) surgery exhibited a lower frequency of analgesic use compared to those who underwent endoscopic full-thickness resection (EFR) surgery ( = 0.038).
A subset of patients undergoing ESD exhibited a need for analgesics within the initial 48-hour postoperative period. Clinicians should carefully assess patients' pain needs and implement appropriate pain relief measures to improve postoperative outcomes.
Chinese Clinical Trial Registry; ChiCTR2300072854.
本研究旨在调查内镜黏膜下剥离术（ESD）或其衍生技术在消化道不同节段术后48小时内的镇痛药物使用频率，以及首次使用镇痛药物的时间。
本回顾性观察性研究基于先前的研究开展。评估的主要结局指标为术后首次使用镇痛药物的时间以及ESD手术后48小时内镇痛药物的使用频率。此外，还分析了影响ESD患者使用止痛药的因素。
纳入研究的2162例患者中，570例（26.36%）术后需要使用镇痛药物。大多数患者在ESD术后8小时内需要首次使用镇痛药物，2小时内需求最高。多因素Cox回归分析表明，术中使用酮咯酸可降低术后2小时内使用镇痛药物的可能性（风险比[HR]=0.35，95%置信区间[CI]：0.15-0.79，P=0.012）。不同手术部位（P=2.043，P=0.843）或手术方法（P=8.647，P=0.071）的患者首次使用镇痛药物的时间无显著差异。同样，不同手术部位在48小时内的镇痛药物使用频率也无显著差异（P=3.817，P=0.576）。然而，与接受内镜全层切除术（EFR）的患者相比，接受内镜黏膜下挖除术（ESE）的患者镇痛药物使用频率较低（P=0.038）。
部分接受ESD的患者在术后最初48小时内需要使用镇痛药。临床医生应仔细评估患者的疼痛需求并采取适当的止痛措施以改善术后结局。
中国临床试验注册中心；ChiCTR2300072854。
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