Risk factors for moderate-to-severe acute pain after hepatobiliary and pancreatic surgery: a single-center retrospective study

Background: Inadequate postoperative analgesia is related to increased risks of many postoperative complications, prolonged hospital stay, declined quality of life, and increased costs. Objectives This study investigated the risk factors for moderate-to-severe postoperative pain during the first 24 hours and 24–48 hours after major hepatobiliary pancreatic surgery. Methods Data of patients who underwent surgery at the Department of Hepatobiliary Surgery in Henan Provincial People's Hospital were collected from January 2018 to August 2020. Univariate and multivariate logistic regression analyses were used to identify the risk factors of postoperative pain. Results In total, 2,180 patients were included in the final analysis. 183 patients (8.4%) suffered moderate-to-severe pain within 24 hours after operation. The independent risk factors associated with moderate-to-severe pain 24 hours after procedures were younger age (OR, 0.97; 95% CI, 0.95 to 0.98, P  < 0.001), lower BMI (OR, 0.94; 95% CI, 0.89 to 0.98, P  = 0.018), open surgery (OR, 0.34; 95% CI, 0.22 to 0.52, P  < 0.001), and postoperative analgesia protocol with sufentanil (OR, 4.38; 95% CI, 3.2 to 5.99, P  < 0.001). Postoperative hospital stay was longer in patients with inadequate analgesia ( P  < 0.05). Conclusion Age, BMI, laparoscopic surgery, and different analgesic drugs were significant predictors of postoperative pain after major hepatobiliary and pancreatic surgery. Trial registration: Chinese Clinical Trial Registry ChiCTR2100049726