{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T08:04:17Z","timestamp":1784707457162,"version":"3.55.0"},"reference-count":34,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_sjpain-2026-0017_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Opioid therapy for chronic pain complicates post-operative pain management. This study evaluated the incidence of failed epidural analgesia, defined as epidural catheter replacement, in opioid-treated chronic pain patients vs. pain-free opioid-na\u00efve controls undergoing elective upper laparotomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2026-0017_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective case\u2013control cohort study of adult patients undergoing elective upper laparotomy with epidural anesthesia (EA) for postoperative pain management. The intervention group comprised chronic pain patients, defined as pain lasting &gt;3\u00a0months with stable daily opioid use. Controls were pain-free opioid-na\u00efve patients. Patients with known illegal opioid use were excluded. A sample size of 75 chronic opioid-treated pain patients and 75\u00a0pain-free patients would allow for detection of a 15\u202f% between group difference in epidural catheter replacement at a 0.05 significance\u00a0level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2026-0017_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventy-five chronic pain patients and 75\u00a0pain-free opioid-na\u00efve controls were included. Chronic pain patients were more often female, had more co-morbidities, and more\u00a0frequently underwent pancreatic resections; liver resections were more common among controls. The median preoperative daily oral morphine equivalent use among chronic pain patients was 45\u202fmg (IQR, 20\u201380). Epidural analgesia failure occurred four times more often in chronic pain patients compared with controls (41.3\u202f% vs. 10.7\u202f%; p&lt;0.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2026-0017_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Chronic preoperative opioid use for pain significantly increased the rate of postoperative epidural catheter replacement. The findings were not explained by external preoperative, technical or surgical factors, supporting further pathophysiological investigations to tailor mechanism based interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/sjpain-2026-0017","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T07:56:13Z","timestamp":1784706973000},"source":"Crossref","is-referenced-by-count":0,"title":["Failed epidural after upper abdominal laparotomy in chronic pain patients with opioid use\u00a0\u2013\u00a0a retrospective case control study"],"prefix":"10.1515","volume":"26","author":[{"given":"Johnny Dohn","family":"Holmgren Andersen","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Center for Cancer and Organ Diseases , Rigshospitalet, University of Copenhagen , Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iryna","family":"Khridina","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Center for Cancer and Organ Diseases , Rigshospitalet, University of Copenhagen , Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danja Lykke","family":"Kristensen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Center for Cancer and Organ Diseases , Rigshospitalet, University of Copenhagen , Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine Puck","family":"Holler","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Center for Cancer and Organ Diseases , Rigshospitalet, University of Copenhagen , Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Rowbotham","sequence":"additional","affiliation":[{"name":"Department of Anesthesia , University of California San Francisco , San Francisco , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eske Kvanner","family":"Aasvang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Center for Cancer and Organ Diseases , Rigshospitalet, University of Copenhagen , Copenhagen , Denmark"},{"name":"Department of Clinical Medicine , University of Copenhagen , Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"2026072207560700689_j_sjpain-2026-0017_ref_001","doi-asserted-by":"crossref","unstructured":"Latremoliere, A, Woolf, CJ. 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