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KMID : 1141320210360010014
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Kosin Medical Journal
2021 Volume.36 No. 1 p.14 ~ p.24
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The Effect of Patient-controlled Intravenous Analgesia (PCIA) on Postoperative Delirium in Patients with Liver Transplantation: a Propensity Score Matching Analysis
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Son Hyo-Jung
Jeong Uk-Jin
Choi Kun-Woong
Park Ju-Yeon
Choi Eun-Ji
Ri Hyun-Su
Lee Tae-Beom
Choi Byung-Hyun
Choi Yoon-Ji
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Abstract
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Objectives: Postoperative opioid use and pain are related to postoperative delirium. This study aims to compare the incidence of delirium in patients with and without patient-controlled intravenous analgesia (PCIA) among liver transplant recipients.
Methods: The medical records of 253 patients who received liver transplantation (LT) from January 2010 to July 2017 in a single university hospital were retrospectively reviewed. Patients were divided into two groups: the patients who had used PCIA (P group, n = 71) and those who did not use PCIA (C group, n = 182) after LT in intensive care unit (ICU). The patient data were collected, which included demographic data, and details about perioperative management and postoperative complications.
Results: There was no difference in the model for end-stage liver disease (MELD) score between the two groups. Postoperative delirium occurred in 10 / 71 (14.08 %) in the P group and 26 / 182 (14.29 %) in the C group after LT, respectively (P = 0.97). After propensity score matching, no differences were observed in the incidence of delirium (P = 0.359) and the time from surgery to discharge (P = 0.26) between the two groups.
Conclusions: Patients with PCIA after LT exhibited no relationship with postoperative delirium. Therefore, it is necessary to actively control postoperative pain using PCIA.
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KEYWORD
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Complication, Liver transplantation, Opioid, Patient-controlled analgesia, Postoperative delirium
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