An investigation of the effect of patient-controlled analgesia on long-term quality of life after major surgery: A prospective cohort study

Ying Hsuan Tai, Hsiang Ling Wu, Shih Pin Lin, Mei Yung Tsou, Kuang Yi Chang

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Background: Chronic pain is a common postoperative complication in patients undergoing major surgery and may significantly affect their quality of life (QOL). Whether patient-controlled analgesia (PCA) can reduce the risk of chronic postsurgical pain and promote long-term QOL is still unclear. Methods: In this prospective cohort study, we followed up patients undergoing major surgery, recorded changes in their postoperative QOL over time using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire and chronic pain events, evaluated the long-term effects of distinct PCA techniques (intravenous, epidural, or none) on their QOL and risk of chronic pain, and explored relevant predictors. The patients' QOL and chronic pain events were collected preoperatively, 3, 6, and 12 months after surgery. Generalized linear mixed models were used to control for individual heterogeneity and adjust for potential confounding factors. Results: We included 328 patients undergoing major surgery from September 22, 2015, to December 31, 2016, in this study. Multivariate regression models showed that patients using intravenous PCA had a better QOL in physical health (adjusted coefficient 3.7, 95% CI, 0.5-8.0) compared with those receiving non-PCA treatments. Distinct PCA techniques did not significantly affect QOL in psychological, social relationship, or environmental domains of the WHOQOL-BREF scale or the risk of chronic postsurgical pain. Conclusion: Patients using intravenous PCA had a better QOL in physical health over time after major surgery, which may have been due to factors other than pain-relieving effects.

Original languageEnglish
Pages (from-to)194-201
Number of pages8
JournalJournal of the Chinese Medical Association
Volume83
Issue number2
DOIs
Publication statusPublished - Jan 1 2020

Keywords

  • Chronic pain
  • Postoperative complication
  • Quality of life

ASJC Scopus subject areas

  • Medicine(all)

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