{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:12:13Z","timestamp":1789186333828,"version":"build-2803163510"},"reference-count":33,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T00:00:00Z","timestamp":1721347200000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,7,3]]},"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to compare the effects of patient-controlled intravenous analgesia (PCIA) with and without low-basal infusion on postoperative hypoxaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A randomised parallel-group non-inferiority trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>The trial was conducted at a grade-A tertiary hospital from December 2021 to August 2022.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>160 adults undergoing gastrointestinal tumour surgery and receiving postoperative PCIA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Participants randomly received a low-basal (0.1 mg\/hour of hydromorphone) or no-basal infusion PCIA for postoperative 48 hours.<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary and secondary outcome measures<\/jats:title><jats:p>Primary outcome was area under curve (AUC) per hour for hypoxaemia, defined as pulse oxygen saturation (SpO<jats:sub>2<\/jats:sub>) &lt;95%. Secondary outcomes included: AUC per hour at SpO<jats:sub>2<\/jats:sub>&lt;90% and &lt;85%, hydromorphone consumption, ambulation time and analgesic outcomes up to 48 hours after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 160 randomised patients, 159 completed the trial. An intention-to-treat analysis showed that AUC per hour (SpO<jats:sub>2<\/jats:sub>&lt;95%) was greater in the low-basal infusion group compared with the no-basal infusion group, with a median difference of 0.097 (95% CI 0.001 to 0.245). Non-inferiority (margin: ratio of means (ROM) of 1.25) was not confirmed since the ROM between the two groups was 2.146 (95% CI 2.138 to 2.155). Hydromorphone consumption was higher in the low-basal group than in the no-basal group (median: 5.2 mg versus 1.6 mg, p&lt;0.001). Meanwhile, there were no differences in the AUC values at the other two hypoxaemia thresholds, in ambulation time, or pain scores between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among the patients receiving hydromorphone PCIA after gastrointestinal tumour resection, low-basal infusion was inferior to no-basal infusion PCIA for postoperative hypoxaemia at SpO<jats:sub>2<\/jats:sub>&lt;95% up to 48 hours after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p>ChiCTR2100054317.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2024-084827","type":"journal-article","created":{"date-parts":[[2024,7,20]],"date-time":"2024-07-20T14:00:17Z","timestamp":1721484017000},"page":"e084827","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of hydromorphone-based patient-controlled intravenous analgesia on postoperative hypoxaemia: a randomised controlled non-inferiority clinical trial"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9814-2952","authenticated-orcid":false,"given":"Yumei","family":"Ma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangying","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nong","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuomin","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jialin","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8221-3541","authenticated-orcid":false,"given":"Ziyu","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxiao","family":"Mu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiejuan","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Meng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailong","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huang","family":"Nie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,7,20]]},"reference":[{"key":"2024072007000904000_14.7.e084827.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.12.008"},{"key":"2024072007000904000_14.7.e084827.2","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000177102.11682.20"},{"key":"2024072007000904000_14.7.e084827.3","doi-asserted-by":"crossref","unstructured":"Hudcova J , McNicol E , Quah C , et al . 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