Impact of early postoperative pain management strategies on complication rates in infants with biliary atresia after Kasai portoenterostomy

Table 1 Comparison of baseline characteristics between the two groups, n (%)/mean ± SD

Variable	n	Male	Female	Age (days)	Weight (kg)	ASA II	ASA III	Preoperative total bilirubin (μmol/L)	Surgery time (minute)
Observation	60	32 (53.3)	28 (46.7)	65.3 ± 12.5	5.2 ± 0.8	38 (63.3)	22 (36.7)	185.6 ± 45.2	215.4 ± 35.6
Control	60	30 (50.0)	30 (50.0)	63.8 ± 11.9	5.1 ± 0.7	35 (58.3)	25 (41.7)	192.1 ± 42.7	208.9 ± 38.1
Statistical test value	-	χ2 = 0.134		t = 0.685	t = 0.721	χ2 = 0.402		t = 0.816	t = 0.965
P value	-	0.714		0.495	0.472	0.526		0.416	0.337

ASA: American Society of Anesthesiologists.

Table 2 Comparison of postoperative complication rates between the two groups, n (%)

Complication	n	Cholangitis	Incision infection	Pulmonary infection	Portal hypertension-related events	Total complications
Observation	60	11 (18.3)	3 (5.0)	3 (5.0)	2 (3.3)	19 (31.7)
Control	60	21 (35.0)	5 (8.3)	10 (16.7)	4 (6.7)	40 (66.7)
χ2	-	4.183	0.782	4.227	0.811	14.286
P value	-	0.041	0.716	0.040	0.678	< 0.001

Table 3 Dynamic changes in postoperative Face, Legs, Activity, Cry, Consolability Pain Scores between the two groups

Group	n	6 hours post-surgery	12 hours post-surgery	24 hours post-surgery	48 hours post-surgery	72 hours post-surgery
Observation	60	2.1 ± 0.8	1.9 ± 0.7	2.3 ± 0.9	2.0 ± 0.6	1.8 ± 0.5
Control	60	5.8 ± 1.2	4.9 ± 1.1	4.5 ± 1.0	3.2 ± 0.8	2.1 ± 0.7
t value	-	19.452	17.832	13.567	9.341	2.789
P value	-	< 0.001	< 0.001	< 0.001	< 0.001	0.006

Table 4 Repeated-measures analysis of variance results for postoperative Face, Legs, Activity, Cry, Consolability Scores between the two groups

Source of variation	Sum of squares	Degrees of freedom	Mean square	F value	P value
Group	350.247	1	350.247	185.632	< 0.001
Time	45.892	4	11.473	35.417	< 0.001
Group × time	37.456	4	9.364	28.915	< 0.001

Table 5 Comparison of postoperative Ramsay sedation scores between the two groups

Group	n	6 hours post-surgery	12 hours post-surgery	24 hours post-surgery	48 hours post-surgery	72 hours post-surgery
Observation	60	2.5 ± 0.5	2.6 ± 0.4	2.4 ± 0.5	2.3 ± 0.4	2.2 ± 0.3
Control	60	2.1 ± 0.6	2.2 ± 0.5	3.2 ± 0.7	2.5 ± 0.5	2.3 ± 0.4
t value	-	4.082	4.915	7.341	2.449	1.500
P value	-	< 0.001	< 0.001	< 0.001	0.016	0.136

Table 6 Repeated-measures analysis of variance results for postoperative Ramsay sedation scores between the two groups

Source of variation	Sum of squares	Degrees of freedom	Mean square	F value	P value
Group	3.215	1	3.215	2.874	0.093
Time	18.942	4	4.736	15.328	< 0.001
Group × time	15.507	4	3.877	12.546	< 0.001

Table 7 Comparison of sedative drug dosage and postoperative recovery indicators between the two groups

Group	n	48 hours opioid use (morphine-equivalent, mg)	Time to first defecation (hours)	PICU stay (days)	Total hospital stay (days)
Observation	60	0.8 ± 0.3	38.5 ± 10.2	2.5 ± 0.8	14.6 ± 3.5
Control	60	1.6 ± 0.5	46.8 ± 12.5	3.2 ± 1.1	17.2 ± 4.8
t value	-	11.283	4.018	4.125	3.456
P value	-	< 0.001	< 0.001	< 0.001	0.001

PICU: Pediatric Intensive Care Unit.