Painkiller administration after endoscopic submucosal dissection surgery: a retrospective real-world study

Area of Science:

• Gastroenterology
• Surgical Oncology
• Pain Management

Background:

• Endoscopic submucosal dissection (ESD) and its derivative techniques are increasingly used for gastrointestinal tumor resection.
• Effective postoperative pain management is essential for patient recovery and satisfaction following these procedures.

Purpose of the Study:

• To determine the frequency and timing of analgesic administration within 48 hours after ESD or its variants.
• To identify factors influencing postoperative analgesic use in patients undergoing ESD.

Main Methods:

• This retrospective observational study analyzed data from 2162 patients who underwent ESD or related procedures.
• Primary outcomes included time to first analgesic administration and analgesic frequency within 48 hours post-surgery.
• Multivariate Cox regression was used to analyze influencing factors.

Main Results:

• 26.36% of patients required postoperative analgesics, with most receiving their first dose within 8 hours (peak within 2 hours) after ESD.
• Intraoperative ketorolac administration significantly reduced the likelihood of early postoperative analgesic use (HR=0.35, p=0.012).
• No significant differences in analgesic timing or frequency were found across different surgical sites or methods, except ESE had lower analgesic use than EFR (p=0.038).

Conclusions:

• A notable proportion of patients require analgesics within 48 hours post-ESD.
• Clinicians should proactively assess and manage postoperative pain to optimize patient outcomes after ESD procedures.