{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T06:00:20Z","timestamp":1785218420897,"version":"3.55.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Patient satisfaction is a key metric for evaluating healthcare quality. Patients undergoing hepatobiliary and pancreatic surgery frequently experience severe postoperative pain, necessitating patient-controlled intravenous analgesia (PCIA). This study aimed to identify factors associated with reduced satisfaction regarding PCIA in this context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective observational study analyzed data from adults receiving PCIA after elective hepatobiliary and pancreatic surgery. Univariate and multivariate logistic regression, employing a forced-entry method to adjust for a comprehensive panel of clinically relevant confounders [including age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA) status, surgical trauma category, surgical approach, malignancy, and major postoperative complications], were used to examine associations between satisfaction and demographics, surgical details, analgesic regimens, postoperative pain (NRS), and adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1,667 patients, 108 (6.5%) were dissatisfied. Multivariable analysis identified moderate-to-severe pain (NRS\u2009&amp;gt;\u20093; aOR\u2009=\u200914.93, 95%CI: 9.52\u201326.32) and hyperhidrosis (aOR\u2009=\u20096.29, 95% CI: 3.05\u201313.89) as strong independent predictors of dissatisfaction (both\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). A significant interaction was found between dezocine and pain severity (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Among patients with NRS\u2009&amp;gt;\u20093, dezocine was associated with significantly lower odds of dissatisfaction (aOR\u2009=\u20090.18, 95% CI: 0.06\u20130.55), corresponding to an \u223c87% reduction, whereas no significant benefit was observed in those with mild pain (aOR\u2009=\u20091.22, 95% CI: 0.33\u20134.68,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.771). Hyperhidrosis was independently associated with rescue analgesia (OR\u2009=\u20098.82,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.016).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dissatisfaction is driven by moderate-to-severe pain and hyperhidrosis. The benefit of dezocine is context-dependent. Optimizing satisfaction requires managing pain, autonomic side effects, and personalized analgesic selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1887173","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T05:37:30Z","timestamp":1785217050000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Patient satisfaction with postoperative analgesia after hepatobiliary and pancreatic surgery: a retrospective analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Wending","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Women\u2019s Hospital, Zhejiang University School of Medicine","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeke","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital, Zhejiang 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China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiliu","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Canji","family":"Shou","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diansan","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital, Zhejiang 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