{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:55:10Z","timestamp":1792043710703,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009752","name":"Futurum - Akademin f\u00f6r H\u00e4lsa och V\u00e5rd, Region J\u00f6nk\u00f6pings l\u00e4ns","doi-asserted-by":"publisher","award":["Futurum\u2010963747"],"award-info":[{"award-number":["Futurum\u2010963747"]}],"id":[{"id":"10.13039\/501100009752","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      Optimising pain management during subcutaneous venous port (SVP) implantation is essential for patient\u2010centred cancer care. However, evidence\u2010based approaches to minimise intraoperative pain remain underexplored. This trial evaluated the clinical effectiveness and safety of the propofol\u2010alfentanil patient\u2010controlled sedation (PCS) technique as an adjunct to local anaesthesia (LA) for pain reduction during SVP implantation. Adult cancer patients at two Swedish anaesthesia departments received either LA\u2009+\u2009PCS or LA alone for SVP implantation. The primary outcome was the maximum intraoperative pain score on an 11\u2010point numeric rating scale (NRS). Safety outcomes included respiratory, haemodynamic and insertion\u2010related complications. Secondary outcomes assessed patient satisfaction and procedural measurements. A total of 340 patients (median age 70 [interquartile range, [IQR] 61\u201376], 51.8% male) were recruited between January 2023 and November 2024. Median intraoperative NRS pain scores were similar between groups (2 [0\u20133] vs. 2 [0\u20133],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.292), with pain scores \u2265\u20094 reported in 22.9% (LA\u2009+\u2009PCS) and 22.2% (LA) (OR 0.96; 95% CI 0.57\u20131.60;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.872). Hypoxia or obstructed airway occurred in 2\/166 (1.2%) patients in the LA\u2009+\u2009PCS group and none in the LA group. Patient satisfaction was high in both groups (10 [10\u201310],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.102). Optimal procedural conditions were reported more frequently with LA\u2009+\u2009PCS (96.4% vs. 82.0%; OR 5.84; 95% CI 2.36\u201314.44;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), without affecting perioperative workflow. Propofol\u2010alfentanil PCS does not significantly reduce intraoperative pain in patients during SVP implantation. Its routine use for pain reduction cannot be recommended. However, PCS may reasonably be offered to patients who prefer procedural sedation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Editorial Comment<\/jats:title>\n                    <jats:p>This randomised clinical trial found that adding patient\u2010controlled sedation with propofol\u2010alfentanil to standard local anaesthesia for subcutaneous venous port implantation does not have an impact on pain scores or patient satisfaction.\u00a0Additional studies focusing on patients experiences and safety are recommended before implementing propofol\u2010alfentanil patient\u2010controlled sedation.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      EudraCT number: 2021\u2010003821\u201031; ClinicalTrials.gov identifier: NCT 05688384.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.70148","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T04:58:30Z","timestamp":1762837110000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Patient\u2010Controlled Sedation in Port Implantation (\n                    <scp>PACSPI<\/scp>\n                    2)\u2014A Randomised Clinical Trial"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5986-4004","authenticated-orcid":false,"given":"Stefanie","family":"Seifert","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Medicine Ryhov County Hospital  J\u00f6nk\u00f6ping Sweden"},{"name":"Department of Biomedical and Clinical Sciences Link\u00f6ping University  Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Knut","family":"Taxbro","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Medicine Ryhov County Hospital  J\u00f6nk\u00f6ping Sweden"},{"name":"Department of Biomedical and Clinical Sciences Link\u00f6ping University  Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1217-2163","authenticated-orcid":false,"given":"Andreas","family":"Nilsson","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Link\u00f6ping University Hospital  Link\u00f6ping Sweden"},{"name":"Department of Medical and Health Sciences Link\u00f6ping University  Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josip","family":"Azman","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Link\u00f6ping University Hospital  Link\u00f6ping Sweden"},{"name":"Pain and Rehabilitation Department Link\u00f6ping University Hospital  Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle S.","family":"Chew","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences Link\u00f6ping University  Link\u00f6ping Sweden"},{"name":"Department of Perioperative Medicine and Intensive Care Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrik","family":"Hammarskj\u00f6ld","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Medicine Ryhov County Hospital  J\u00f6nk\u00f6ping Sweden"},{"name":"Department of Biomedical and Clinical Sciences Link\u00f6ping University  Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"2025 World Health Organization Global Cancer Burden Growing Amidst Mounting Need for Services. 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