{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T14:58:02Z","timestamp":1747148282237,"version":"3.40.5"},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Thoracic epidural analgesia (TEA) and intravenous patient\u2010controlled analgesia (IV\u2010PCA) are widely used to mitigate immediate postoperative pain; however, their effects on long\u2010term disability\u2010free survival are poorly documented. This study aimed to compare the effects of postoperative TEA and IV\u2010PCA on disability\u2010free survival in patients who underwent thoracic or abdominal surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This post hoc analysis of a prospective observational study included 845 inpatients aged \u226555\u2009years that underwent elective thoracic and abdominal surgery between 1 April 2016 and 28 December 2018 in a tertiary care hospital. Inverse probability of treatment weighted (IPTW) using stabilized inverse propensity scores was adopted to minimize bias. The primary outcome in this study was disability\u2010free survival, defined as survival with a 12\u2010item World Health Organization Disability Assessment Schedule 2.0 score of &lt;16%, assessed at 3\u2009months and 1\u2009year after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The final analysis included 601 patients who received TEA and 244 who received IV\u2010PCA. After IPTW, the weighted incidence of disability\u2010free survival at 3\u2009months and 1\u2009year was 60.5% and 61.4% in the TEA group and 78.3% and 66.2% in the IV\u2010PCA group, respectively. The adjusted OR for disability\u2010free survival at 3\u2009months and 1\u2009year was 0.84 (95% confidence interval [CI]: 0.50\u20131.39) and 1.21 (95% CI: 0.72\u20132.05), respectively, for the TEA group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>No significant differences were observed in the disability\u2010free survival at 3\u2009months and 1\u2009year after elective thoracic and abdominal surgery in patients aged \u226555\u2009years who received TEA or IV\u2010PCA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance statement<\/jats:title><jats:p>This study is the first in our setting to document the long\u2010term effects of patient\u2010controlled analgesia. In a post hoc analysis of our prospective cohort study, we show that although differences in chronic postsurgical pain exist at 3\u2009months post\u2010surgery, disability\u2010free survival rates at 1\u2009year do not differ irrespective of the choice of patient\u2010controlled analgesia. The findings of this study highlight the need for shared decision\u2010making between clinicians and patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.2266","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T11:14:02Z","timestamp":1711019642000},"page":"1356-1365","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison between the effects of epidural and intravenous patient\u2010controlled analgesia on postoperative disability\u2010free survival in patients undergoing thoracic and abdominal surgery: A post hoc analysis"],"prefix":"10.1002","volume":"28","author":[{"given":"S.","family":"Hirai","sequence":"first","affiliation":[{"name":"Department of Perioperative Management Center Nara Medical University Hospital  Nara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5285-257X","authenticated-orcid":false,"given":"M.","family":"Ida","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Nara Medical University  Nara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.","family":"Naito","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Nara Medical University  Nara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Nara Medical University  Nara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002386"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/papr.12091"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2017.01.001"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2013.09.014"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15256"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfab158"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.12.008"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/rapm\u20102020\u2010101933"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000003835"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2021.04.002"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001893.pub2"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000004132"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630\u2010022\u201002247\u20108"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000333274.63501.ff"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12603\u2010009\u20100214\u20107"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00540\u2010023\u201003178\u20104"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000003951"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000003834"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2019.08.004"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001536"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010020\u201005462\u2010w"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2022.03.015"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1801601"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aew466"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/rapm\u20102020\u2010101708"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2022.05.029"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aew383"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010434.pub2"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2019.4620"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000003240"},{"key":"e_1_2_7_32_1","unstructured":"The European Society of Regional Anaesthesia & Pain Therapy. 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