{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T19:18:15Z","timestamp":1787858295678,"version":"build-2784847793"},"reference-count":31,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T00:00:00Z","timestamp":1670544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cContinuous improvement of anesthesia and perioperative safety project\u201d of West China Hospital, Sichuan University, China","award":["zygd20005"],"award-info":[{"award-number":["zygd20005"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The optimal dosage for opioids given to patients after surgery for pain management remains controversial. We examined the association of higher post-surgical opioid use with pain relief and recovery. Methods: We retrospectively enrolled adult patients who underwent elective abdominal surgery at our hospital between August 2021 and April 2022. Patients were divided into the \u201chigh-intensity\u201d or \u201clow-intensity\u201d groups based on their post-surgical opioid use. Generalized estimating equation models were used to assess the associations between pain scores at rest and during movement on days 1, 2, 3, and 5 after surgery as primary outcomes. The self-reported recovery and incidence of adverse events were analyzed as secondary outcomes. Results: Among the 1170 patients in the final analysis, 293 were in the high-intensity group. Patients in the high-intensity group received nearly double the amount of oral morphine equivalents per day compared to those in the low-intensity group (84.52 vs. 43.80), with a mean difference of 40.72 (95% confidence interval (CI0 38.96\u201342.48, p &lt; 0.001) oral morphine equivalents per day. At all timepoints, the high-intensity group reported significantly higher pain scores at rest (difference in means 0.45; 95% CI, 0.32 to 0.58; p &lt; 0.001) and during movement (difference in means 0.56; 95% CI, 0.41 to 0.71; p &lt; 0.001) as well as significantly lower recovery scores (mean difference (MD) \u22128.65; 95% CI, \u221210.55 to \u22126.67; p &lt; 0.001). A post hoc analysis found that patients with moderate to severe pain during movement were more likely to receive postoperative high-intensity opioid use. Furthermore, patients in the non-high-intensity group got out of bed sooner (MD 4.31 h; p = 0.001), required urine catheters for shorter periods of time (MD 12.26 h; p &lt; 0.001), and were hospitalized for shorter periods (MD 1.17 days; p &lt; 0.001). The high-intensity group was at a higher risk of chronic postsurgical pain (odds ratio 1.54; 95% CI, 1.14 to 2.08, p = 0.005). Conclusions: High-intensity opioid use after elective abdominal surgery may not be sufficient for improving pain management or the quality of recovery compared to non-high-intensity use. Our results strengthen the argument for a multimodal approach that does not rely so heavily on opioids.<\/jats:p>","DOI":"10.3390\/jcm11247320","type":"journal-article","created":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T04:46:46Z","timestamp":1670561206000},"page":"7320","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Opioid Dose, Pain, and Recovery following Abdominal Surgery: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"11","author":[{"given":"Dongxu","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, West China Hospital, Sichuan University, No. 37 Wainan Guoxue Rd., Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Wainan Guoxue Rd., Chengdu 610041, China"},{"name":"West China School of Nursing, Sichuan University, No. 37 Wainan Guoxue Rd., Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, West China Fourth Hospital, Sichuan University, No. 18, Sect. 3 People South Road, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huolin","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, West China Hospital, Sichuan University, No. 37 Wainan Guoxue Rd., Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, West China Hospital, Sichuan University, No. 37 Wainan Guoxue Rd., Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, West China Hospital, Sichuan University, No. 37 Wainan Guoxue Rd., Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1097\/ALN.0b013e31828866b3","article-title":"Pain intensity on the first day after surgery","volume":"118","author":"Gerbershagen","year":"2013","journal-title":"Anesthesiology"},{"key":"ref_2","first-page":"767","article-title":"Techniques to ensure adequate portal flow in the presence of splenorenal shunts","volume":"13","author":"Perkins","year":"2007","journal-title":"Liver Transplant."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2579","DOI":"10.1007\/s00268-019-05050-7","article-title":"Predictors of post-operative pain and opioid consumption in patients undergoing liver surgery","volume":"43","author":"Behman","year":"2019","journal-title":"World J. 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