Perioperative Anesthetic Management in Cancer Patients Receiving Strong Opioids: A Retrospective Study from a Single Center with Palliative Care Team Involvement.

Abstract

There are no clinical guidelines for the perioperative management of cancer pain among opioid users, and a lack of literature exists concerning this topic. This study aimed to retrospectively investigate the actual perioperative management of patients with cancer who received general anesthesia while using strong opioids. We conducted a chart review of the perioperative management of patients with cancer who received general anesthesia while using strong opioids. The primary outcome was the number of additional administration of analgesics during the first 24 h after surgery, except for PCA (patient-controlled analgesia). The secondary outcome was the prevalence of cases of poor pain control after surgery, which was defined in this study as "patients who received additional administration of analgesics more than four times (excluding PCA) within the first 24 h after surgery." Fifty-two patients were included in this analysis. The primary outcome was one per day (interquartile range, 0-4). By contrast, the secondary outcome was 17.3%. Preoperative pelvic visceral pain (cancer pain) was the most common; it was associated with poor pain control. In this area, it is important to evaluate cancer and non-cancer pain accurately and provide appropriate analgesia after surgery.