Alex H Konstantatos1, Taidi Zhong2, Eldho Paul3, Sharon Tsang4, Suming Tian2, Minjun Liu5, Yuyuan Liang5, Yuanyuan Tian4, Shina Qiao5, William K K Wu6, Matthew T V Chan7. 1. Department of Anaesthesia and Perioperative Medicine, Alfred Hospital, Monash University, Melbourne, VIC, Australia. 2. Department of Anaesthesia, Zhejiang University School of Medicine, Sir Run Run Shaw Hospital, Hangzou, China. 3. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. 4. Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. 5. Sir Run Run Shaw Hospital, Hangzou, China. 6. State Key Laboratory of Digestive Disease, Department of Anaesthesia and Intensive Care, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. 7. Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. mtvchan@cuhk.edu.hk.
Abstract
PURPOSE: The objective of this prospective observational study was to investigate the interactions between cultural background, healthcare environment, and postoperative pain experience. METHODS: We enrolled 128 Chinese patients living in rural mainland China and 134 patients in Hong Kong with a higher level of Western cultural influences (defined by educational attainment, place of residence, and ability to understand English). All patients had major abdominal surgery and received patient-controlled analgesia with intravenous morphine for postoperative pain relief. The primary endpoint was total opioid requirement up to 48 hr after surgery. Other measures included pain intensity, opioid-related side effects, and genetic markers for opioid responsiveness. RESULTS: The mean (95% confidence interval) cumulative opioid requirement, expressed as morphine equivalent, during the first 48 hr after surgery was significantly less in patients from mainland China (18.8 [15.7 to 22] mg) compared with patients from Hong Kong (42.0 [38.3 to 45.6] mg, P < 0.0001). In a multivariable analysis, opioid requirement was influenced by ethnicity, duration of surgery, and severity of pain upon admission to the postanesthetic care unit. CONCLUSIONS: These results suggest that postoperative pain behaviours and opioid requirement may be influenced by cultural background and healthcare environment in two populations of Chinese descent. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry (ACTRN12614000601639); registered 6 May, 2014.
PURPOSE: The objective of this prospective observational study was to investigate the interactions between cultural background, healthcare environment, and postoperative pain experience. METHODS: We enrolled 128 Chinese patients living in rural mainland China and 134 patients in Hong Kong with a higher level of Western cultural influences (defined by educational attainment, place of residence, and ability to understand English). All patients had major abdominal surgery and received patient-controlled analgesia with intravenous morphine for postoperative pain relief. The primary endpoint was total opioid requirement up to 48 hr after surgery. Other measures included pain intensity, opioid-related side effects, and genetic markers for opioid responsiveness. RESULTS: The mean (95% confidence interval) cumulative opioid requirement, expressed as morphine equivalent, during the first 48 hr after surgery was significantly less in patients from mainland China (18.8 [15.7 to 22] mg) compared with patients from Hong Kong (42.0 [38.3 to 45.6] mg, P < 0.0001). In a multivariable analysis, opioid requirement was influenced by ethnicity, duration of surgery, and severity of pain upon admission to the postanesthetic care unit. CONCLUSIONS: These results suggest that postoperative pain behaviours and opioid requirement may be influenced by cultural background and healthcare environment in two populations of Chinese descent. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry (ACTRN12614000601639); registered 6 May, 2014.
Authors: C Aun; I T Houghton; K Chan; R H Carley; N P Salmon; Y M Lams; J A Thornton Journal: Anaesth Intensive Care Date: 1988-11 Impact factor: 1.669
Authors: Marium M Raza; Ruth Zaslansky; Debra B Gordon; Jeanne M Wildisen; Marcus Komann; Ulrike M Stamer; Dale J Langford Journal: J Clin Med Date: 2021-04-27 Impact factor: 4.241