AI Article Synopsis
- PIPAC (Pressurized Intraperitoneal Aerosol Chemotherapy) is a new surgical method to treat peritoneal carcinomatosis, and this study examines how body mass index (BMI) affects postoperative pain and opioid use after the procedure.
- Researchers analyzed pain levels and opioid consumption from 100 PIPAC procedures, categorizing patients based on their BMI while assessing pain through a visual analogue scale.
- The findings revealed that BMI did not significantly impact pain or opioid use, but moderate to severe pain and the presence of synchronous peritoneal carcinomatosis were linked to higher opioid consumption.
Article Abstract
Purpose: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new surgical technique, developed for the treatment of peritoneal carcinomatosis (PC). In this retrospective observational study we assessed the impact of body mass index (BMI) on postoperative pain and opioid consumption.
Methods: We analyzed pain scores after 100 PIPAC procedures using either oxaliplatin or doxorubicin-cisplatin performed in 49 patients with PC between July 2016 and September 2020. The patients were divided into 3 groups (BMI <18.5, 18.5 ≥ BMI < 25, BMI≥25). Pain was self-rated on a visual analogue scale (VAS) from 0 to 10.
Results: Univariate logistic regression analysis identified oxaliplatin and PCI score to be associated with moderate to severe pain (VAS 4-10 at 8 am D1) after adjustment on BMI (OR [95% CI]; 3.26[1.00 - 10.65] p=0.050) and (OR [95% CI]; 1.09[1.01 - 1.17] p=0.019). The level of pain appeared significantly different between the treatment groups (median 2.5[0; 5] vs 0[0; 2.5] p=0.0017) irrespective of BMI (p =0.705 and p=0.118). Multivariate logistic regression analysis identified moderate to severe pain and synchronous PC to be associated with greater use of opioids (OR [95% CI]: 3.91 [1.24 - 12.32]) and (OR [95% CI]: 5.16 [1.71 - 15.58]; respectively. Opioids were administered after 45 procedures (45%) and was comparable between the treatment groups. Opioid administration and length-of-stay were similar among BMI bands.
Conclusion: BMI is not related to postoperative pain or opioid use, howevermoderate to severe pain and synchronous PC are factors associated with requiring opioids.
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| http://dx.doi.org/10.1007/s12029-023-00957-w | DOI Listing |
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