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Acta Anaesthesiologica Scandinavica
Article . 2025 . Peer-reviewed
License: CC BY NC ND
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Intraoperative opioid administrations, rescue doses in the post‐anaesthesia care unit and clinician‐perceived factors for dose adjustments in adults: A Danish nationwide survey

Authors: Trang Xuan Minh Tran; Mik Wetterslev; Anders Kehlet Nørskov; Christian Sylvest Meyhoff; Markus Harboe Olsen; Theis Skovsgaard Itenov; Ole Mathiesen; +1 Authors

Intraoperative opioid administrations, rescue doses in the post‐anaesthesia care unit and clinician‐perceived factors for dose adjustments in adults: A Danish nationwide survey

Abstract

AbstractBackgroundThe impact of demographic‐ and surgical factors on individual perioperative opioid requirements is not fully understood. Anaesthesia personnel adjust opioid administrations based on their own clinical experience, expert opinions and local guidelines. This survey aimed to assess the current practice of anaesthesia personnel regarding intraoperative opioid treatment for postoperative analgesia and rescue opioid dosing strategies in the post‐anaesthesia care unit in Denmark.MethodsWe conducted a cross‐sectional online survey with 37 questions addressing pain management and opioid‐dosing strategies. Local site investigators from 46 of 47 public Danish anaesthesia departments distributed the survey. Data collection took place from 5 February to 30 April 2024.ResultsOf the 4187 survey participants, 2025 (48%) answered. Intra‐ and postoperative opioid doses were adjusted based on chronic pain, age, preoperative opioid use, body weight and type of surgery. Between 84% and 89% of respondents adhered to and had perioperative pain management guidelines available. Respondents preferred intraoperative fentanyl (44%) and morphine (36%) to prevent postoperative pain. Median intraoperative intravenous morphine equivalents ranged from 0.12 to 0.38 mg/kg in clinical scenarios. In these cases, the following variables were assembled in different combinations to assess their impact on dosing: age (30 vs. 65 years), sex (female vs. male), ASA score (1 vs. 3) and type of surgery (anterior cruciate ligament vs. laparoscopic cholecystectomy surgery). Respondents preferred intravenous morphine and fentanyl for moderate and severe postoperative pain, respectively. Median postoperative rescue doses were 0.06–0.12 mg/kg in clinical scenarios based on shifting combinations of the variables: age (30 vs. 65 years), ASA score (1 vs. 3) and degree of expected pain (moderate vs. severe).ConclusionRespondents preferred fentanyl and morphine for postoperative pain control with considerable variation in choice of opioid and morphine equivalent dose. Respondents expressed that guidelines were highly available and strongly adhered to. Opioid dosing was predominantly guided by chronic pain, age, preoperative opioid use, body weight and type of surgery.

Country
Denmark
Keywords

Adult, Male, Analgesics, Pain, Postoperative, Intraoperative Care, Analgesics, Opioid/administration & dosage, Pain, Postoperative/drug therapy, Denmark, Pain, Fentanyl/administration & dosage, Middle Aged, Intraoperative Care/methods, Analgesics, Opioid, Fentanyl, Postoperative/drug therapy, Cross-Sectional Studies, Surveys and Questionnaires, Humans, Pain Management, Female, Opioid/administration & dosage, Pain Management/methods, Research Article, Aged

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
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