{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:11:06Z","timestamp":1785413466543,"version":"3.56.0"},"reference-count":25,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Postoperative opioid requirements vary substantially after gastrointestinal surgery. Oxycodone-based patient-controlled intravenous analgesia (PCIA) is used for postoperative pain control, but perioperative factors associated with early postoperative oxycodone requirement remain insufficiently defined. This study investigated factors associated with 48 h oxycodone consumption after gastrointestinal surgery. Methods: This single-center retrospective cohort study included 493 adults who underwent elective gastrointestinal surgery and received oxycodone-based PCIA between January and December 2025. The primary outcome was cumulative oxycodone consumption within 48 h after surgery. Multivariable linear regression was used for the primary continuous-outcome analysis. An exploratory analgesia-adjusted model additionally included regional block, incisional local infiltration, and routine postoperative non-opioid analgesic use. High consumption, defined as a 48 h dose &gt;38 mg, was evaluated using exploratory logistic regression models. Results: The median 48 h oxycodone consumption was 34 mg (interquartile range, 27\u201338 mg), and 105 patients (21.3%) had high consumption. In the prespecified clinical continuous-outcome model, gastric surgery, rectal surgery, open surgery, converted-to-open surgery, radical resection, and longer operation time were associated with higher 48 h oxycodone consumption, whereas older age was associated with lower consumption. After adjustment for available analgesia-related variables, the main associations remained broadly stable, although the association for converted-to-open surgery was attenuated. Regional block and incisional local infiltration were associated with lower 48 h oxycodone consumption in the analgesia-adjusted model. In the exploratory logistic models, younger age, rectal surgery, open or converted-to-open surgery, radical resection, and longer operation time were associated with high consumption. Body mass index (BMI) was not independently associated with oxycodone requirement. Conclusions: Age and procedure-related characteristics were associated with 48 h oxycodone requirement after gastrointestinal surgery. These routinely available perioperative factors may help identify patients who warrant earlier postoperative pain reassessment, closer acute pain service follow-up, and individualized multimodal analgesic planning. Prospective multicenter validation is required before formal risk-stratified analgesic protocols can be recommended.<\/jats:p>","DOI":"10.3390\/jcm15155957","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:38:54Z","timestamp":1785411534000},"page":"5957","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative Factors Associated with 48-Hour Postoperative Oxycodone Requirement After Gastrointestinal Surgery: A Single-Center Retrospective Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Yu-qian","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Quanzhou First Hospital, Quanzhou 362000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan-dan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Quanzhou First Hospital, Quanzhou 362000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-quan","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Quanzhou First Hospital, Quanzhou 362000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-xian","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Quanzhou First Hospital, Quanzhou 362000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun-yuan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Quanzhou First Hospital, Quanzhou 362000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,30]]},"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: A prospective cohort study comparing 179 surgical procedures","volume":"118","author":"Gerbershagen","year":"2013","journal-title":"Anesthesiology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1097\/EJA.0000000000000366","article-title":"Current issues in postoperative pain management","volume":"33","author":"Rawal","year":"2016","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Wu, Y., Tian, L., Li, C., Liu, M., Qiao, S., Zhang, W., Tian, S., and Chen, G. (2021). Factors affecting sufentanil consumption for intravenous controlled analgesia after hepatectomy: Retrospective analysis. BMC Anesthesiol., 21.","DOI":"10.1186\/s12871-021-01526-z"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1185\/030079908X253708","article-title":"Oxycodone: A review of its use in the management of pain","volume":"24","author":"Riley","year":"2008","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s40122-019-0122-4","article-title":"Intravenous oxycodone versus other intravenous strong opioids for acute postoperative pain control: A systematic review of randomized controlled trials","volume":"8","author":"Raff","year":"2019","journal-title":"Pain Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1097\/CM9.0000000000002259","article-title":"Comparison of oxycodone and sufentanil in patient-controlled intravenous analgesia for postoperative patients: A meta-analysis of randomized controlled trials","volume":"136","author":"Feng","year":"2023","journal-title":"Chin. Med. J."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Zhou, Y., Huang, X., Chang, H., Sun, H., Xie, W., Pan, Z., Zhang, F., and Liao, Q. (2023). The optimal dose of oxycodone in PCIA after laparoscopic surgery for gastrointestinal cancer in elderly patients: A randomized controlled trial. Front. Surg., 10.","DOI":"10.3389\/fsurg.2023.1111376"},{"key":"ref_8","first-page":"1240","article-title":"Factors influencing hydromorphone use in patient-controlled intravenous analgesia for 48 h after gynecologic surgery: A retrospective analysis","volume":"46","author":"Wu","year":"2025","journal-title":"Int. J. Anesthesiol. Resusc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"370","author":"Altman","year":"2007","journal-title":"Lancet"},{"key":"ref_10","unstructured":"R Core Team (2026). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1097\/DCR.0000000000002650","article-title":"Clinical practice guidelines for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons and the Society of American Gastrointestinal and Endoscopic Surgeons","volume":"66","author":"Irani","year":"2023","journal-title":"Dis. Colon. Rectum"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1002\/bjs.9582","article-title":"Consensus guidelines for enhanced recovery after gastrectomy: Enhanced Recovery After Surgery (ERAS\u00ae) Society recommendations","volume":"101","author":"Mortensen","year":"2014","journal-title":"Br. J. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/0304-3959(95)00128-X","article-title":"Age is the best predictor of postoperative morphine requirements","volume":"64","author":"Macintyre","year":"1996","journal-title":"Pain"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s44158-024-00182-2","article-title":"Influence of aging on opioid dosing for perioperative pain management: A focus on pharmacokinetics","volume":"4","author":"Mercadante","year":"2024","journal-title":"J. Anesth. Analg. Crit. Care"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jpain.2015.12.008","article-title":"Management of postoperative pain: A clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists\u2019 Committee on Regional Anesthesia, Executive Committee, and Administrative Council","volume":"17","author":"Chou","year":"2016","journal-title":"J. Pain"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"American Society of Anesthesiologists Task Force on Acute Pain Management (2012). Practice guidelines for acute pain management in the perioperative setting: An updated report. Anesthesiology, 116, 248\u2013273.","DOI":"10.1097\/ALN.0b013e31823c1030"},{"key":"ref_17","first-page":"1048","article-title":"The value of \u201cmultimodal\u201d or \u201cbalanced analgesia\u201d in postoperative pain treatment","volume":"77","author":"Kehlet","year":"1993","journal-title":"Anesth. Analg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/S0952-8180(01)00320-8","article-title":"Multimodal analgesia for postoperative pain control","volume":"13","author":"Jin","year":"2001","journal-title":"J. Clin. Anesth."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1001\/jamasurg.2017.0898","article-title":"Postoperative multimodal analgesia pain management with nonopioid analgesics and techniques: A review","volume":"152","author":"Wick","year":"2017","journal-title":"JAMA Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e115","DOI":"10.1016\/j.anclin.2017.01.018","article-title":"Essential elements of multimodal analgesia in enhanced recovery after surgery (ERAS) guidelines","volume":"35","author":"Beverly","year":"2017","journal-title":"Anesthesiol. Clin."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1097\/ALN.0b013e3181aae87a","article-title":"Predictors of postoperative pain and analgesic consumption: A qualitative systematic review","volume":"111","author":"Ip","year":"2009","journal-title":"Anesthesiology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1002\/ejp.886","article-title":"Psychological correlates of acute postsurgical pain: A systematic review and meta-analysis","volume":"20","author":"Plotek","year":"2016","journal-title":"Eur. J. Pain"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e170504","DOI":"10.1001\/jamasurg.2017.0504","article-title":"New persistent opioid use after minor and major surgical procedures in US adults","volume":"152","author":"Brummett","year":"2017","journal-title":"JAMA Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1097\/EJA.0000000000000319","article-title":"Chronic postsurgical pain in Europe: An observational study","volume":"32","author":"Fletcher","year":"2015","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1016\/S0140-6736(19)30352-6","article-title":"Transition from acute to chronic pain after surgery","volume":"393","author":"Glare","year":"2019","journal-title":"Lancet"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/5957\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:53:10Z","timestamp":1785412390000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/5957"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,30]]},"references-count":25,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["jcm15155957"],"URL":"https:\/\/doi.org\/10.3390\/jcm15155957","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,30]]}}}