Early Discontinuation of Opioid-Based Intravenous Patient-Controlled Analgesia After Single-Port Adnexal Laparoscopy: Incidence, Reasons, and Postoperative Outcomes

Background/Objectives: Opioid-based intravenous patient-controlled analgesia (IV-PCA) provides postoperative analgesia but can cause adverse effects that lead to early discontinuation. In relatively limited procedures such as single-port access (SPA) adnexal laparoscopy, the balance between analgesic benefit and opioid-related adverse effects remains uncertain. We evaluated the frequency of and recorded reasons for early IV-PCA discontinuation, associated factors, postoperative pain, and length of stay.

Methods

We retrospectively reviewed 431 patients who received IV-PCA after single-port access (SPA) adnexal laparoscopy at two institutions. Early discontinuation was defined as permanent cessation before completion of the planned course. Associations with demographic and operative factors, concurrent continuous wound infiltration, and treating institution were examined. Repeated-measures analysis accounted for discontinuation timing and repeated pain assessments.