Postoperative sufentanil intravenous patient-controlled analgesia within the first 24 hours: a retrospective study

Intravenous patient-controlled analgesia (IV-PCA) is recommended for postoperative systemic analgesia by the American Pain Society. As there is no efficacy advantage and a higher probability of adverse events, routine basal infusion of opioids is not recommended for opioid-naïve adults. However, the opioids referred to in postoperative pain management guidelines were mainly morphine. Nowadays, sufentanil is widely used in postoperative acute pain management. In this retrospective study, we evaluated and compared the analgesic effect, PCA use, as well as adverse events among different basal infusions with sufentanil-based postoperative PCA.

The data of 322 eligible postoperative patients who received sufentanil-based IV-PCA from January 2018 to December 2019 were collected in this study. According to the settings of background infusions, patients were allocated to 3 groups: 2, 1, or 0.5 mL/hour. The primary endpoint was PCA attempts and successful delivery. We also evaluated the occurrence of adverse events associated with sufentanil-based PCA and the intensity of postoperative pain using the Numeric Rating Scale (NRS).

PCA attempts, successful deliveries, total volume of PCA and patient NRS scores were significantly different between the 3 groups (P<0.05). Through pairwise comparison, there was only a statistical difference between the 2 mL/hour and the 0.5 mL/hour group in PCA attempts, successful deliveries, and total volumes of PCA. There were no statistical differences in adverse events between groups (P>0.05).

We found that a smaller background infusion with sufentanil required more bolus infusions and a higher total volume of PCA within 24 hours after surgery. However, NRS scores were higher in the smaller background infusion group. Our results highlight the need for further studies to optimize doses for sufentanil IV-PCA basal infusions, which will also provide useful information to enhance the quality of pain control in the future.