PD09.03. Are Pulmonary Complications Associated With Early Postoperative Pain After Oesophagectomy Within a Multimodal Analgesia Pathway?

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ID: 325751
2026
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Abstract
Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer – early outcomes and complications Background Pulmonary complications are common after oesophagectomy and may plausibly relate to thoracic pain, splinting and reduced mobilisation. We evaluated whether early postoperative pain scores differ between patients with and without pulmonary complications within a multimodal analgesia pathway. Methods A retrospective audit of consecutive oesophagectomy patients managed within a multimodal analgesia pathway. Overall, thoracic and abdominal pain scores (0–10 NRS) were recorded on postoperative days (POD) 1–5; for each POD, the maximum recorded score was used. Patients with pulmonary complication status not coded or with incomplete POD1–5 overall pain data were excluded. Pain burden was summarised as area-under-the-curve (AUC) across POD1–5 (trapezoidal method) for overall, thoracic and abdominal pain. Peak overall pain was defined as the maximum POD1–5 overall score. Groups were compared using Mann–Whitney U tests. Results Of 138 patients, 126 had pulmonary complications and complete POD1–5 overall pain data (pulmonary complication 44/126, 34.9%). Overall pain burden did not differ between groups (median AUC [IQR]: no pulmonary complication 10.0 [5.63–15.75] vs pulmonary complication 9.75 [6.13–14.81]; p=0.52). Peak overall pain was similar (median [IQR]: 4.0 [3.0–6.0] vs 4.25 [2.75–5.5]; p=0.45). Thoracic pain burden was also similar (median AUC [IQR]: 11.75 [6.25–17.38] vs 13.0 [5.25–18.63]; p=0.82). Abdominal pain burden did not differ (median AUC [IQR]: 7.75 [3.50–14.38] vs 7.0 [1.75–11.25]; p=0.26). Conclusion In this cohort managed within a multimodal analgesia pathway, pulmonary complications were not associated with higher early postoperative pain burden (overall, thoracic or abdominal) or peak overall pain across POD1–5. These findings suggest that early pain scores alone may not explain pulmonary complication risk and support exploring other modifiable drivers (e.g., mobilisation, respiratory physiotherapy uptake, opioid exposure and complications severity) in future work.
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Authors Jakub Chmelo, Christopher Browell, Natawadee Chantima, Emma Flynn, Hollie Dixon, Emily Duncan, Nicola Stephens, Alexander Phillips
Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.142
URL
https://doi.org/10.1093/dote/doag077.142
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