Effect of opioid-sparing analgesia on incidence of sepsis in severely burned patients: a retrospective cohort study
10.3760/cma.j.cn131073.20230428.00716
- VernacularTitle:少阿片类药物镇痛对严重烧伤患者脓毒症发生率的影响：回顾性队列研究
- Author:
Qiulan HE
1
;
Guohui MO
;
Ying QIN
;
Runcheng HUANG
;
Qi LIU
;
Caiyun CHEN
;
Zhongxing WANG
Author Information
1. 中山大学附属第一医院麻醉科，广州 510080
- Keywords:
Analgesics, opioid;
Burns;
Sepsis
- From:
Chinese Journal of Anesthesiology
2023;43(7):840-845
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effects of opioid-sparing analgesia on the incidence of sepsis in severely burned patients in the retrospective cohort study.Methods:The clinical data from patients with severe burns admitted to three teaching hospitals in Guangdong from 2011 to 2020 were retrospectively extracted and analyzed. The patients were divided into 2 groups based on the analgesic regimen within 30 days after injury: continuous opioids analgesia group (continuous opioid infusion at a relative constant rate for more than 72 h) and opioid-sparing analgesia group (patient-controlled intravenous analgesia/intermittent administration/opioid-free analgesia). Patient′s age, severity of burn, inhalation injury and basal pain score at rest were matched by the propensity score at a 1∶1 ratio. The primary outcome measure was the occurrence of sepsis within 90 days of admission. Secondary outcome measures included 30-day and 90-day all-cause mortality, clinical diagnosis of multiple organ dysfunction syndrome, and prevalence of burn wound infection. The amount of opioid used was also recorded.Results:A total of 328 severely burned patients were finally enrolled, with 145 patients in continuous opioid analgesia group and 183 patients in opioid-sparing analgesia group, and 110 pairs of patients (220 cases) were finally matched by the propensity score.Compared with continuous opioid analgesia group, the total consumption of opioid, daily consumption per analgesia, and consumption per burn area were significantly decreased, and the incidence of sepsis and wound infection was decreased( P<0.05), and no significant change was found in the incidence of multiple organ dysfunction syndrome, 30-day and 90-day all-cause mortality in opioid-sparing analgesia group( P>0.05). Conclusions:Compared with the continuous opioid analgesia regimen, opioid-sparing analgesia can reduce the risk of sepsis in severely burned patients.
