Acta anaesthesiologica Scandinavica · 2026
The OPIAID Zone Tool (Version 0.5) as a Composite Outcome for Postoperative Pain Management Quality.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Karlsen Anders Peder Højer, Tran Trang Xuan Minh, Meyhoff Christian S, Lunn Troels Haxholdt, Mathiesen Ole, Olsen Markus Harboe
Аннотация
BACKGROUND: Managing postoperative pain while minimising opioid-related adverse drug events (ORADEs) remains a clinical challenge. The OPIAID Zone Tool is a visual scoring system designed to evaluate pain and ORADEs together. It has pain on the x-axis and ORADEs on the y-axis and categorises patients into zones of increased combined symptom burden. We aimed to evaluate the OPIAID Zone Tool, assess its association with postoperative outcomes and explore alternative versions.
METHODS: This prospective observational cohort pilot study included 145 adult patients undergoing orthopaedic and abdominal surgery under general anaesthesia with postoperative care in the post-anaesthesia care unit at Bispebjerg Hospital, Denmark. The primary outcome was the OPIAID Zone Tool score (version 0.5). Secondary analyses assessed associations with patient-perceived health (EQ-VAS), quality of recovery (QoR-PACU) and time to discharge readiness in PACU, evaluated using R2, AIC and BIC.
RESULTS: Distribution across OPIAID Zones was broad (Zone 0: 13.8%, Zone 1: 6.9%, Zone 2: 22.1%, Zone 3: 18.6%, Zone 4: 20.0%, Zone 5: 18.6%), without clear clustering and with a tendency towards pain-dominant profiles. The OPIAID Zone Tool score was significantly associated with EQ-VAS (R2 = 0.39), QoR-PACU (R2 = 0.35) and PACU discharge readiness (R2 = 0.50), showing stronger overall associations than pain and ORADEs assessed separately.
CONCLUSION: The OPIAID Zone Tool (version 0.5) combines pain and ORADE scores into a single metric while simultaneously visualising their distribution across the population. The Zone score was associated with patient-centred outcomes and outperformed pain and ORADEs assessed separately, though a risk of overfitting cannot be ruled out. Further refinement and prospective validation are planned to optimise the tool and confirm its clinical utility.
EDITORIAL COMMENT: How high is the quality of the early postoperative analgesia that is being delivered? This study presents a model and instrument for quantifying quality of early postoperative analgesia combining treatments, pain reporting and opioid-related adverse events. The performance of the new instrument is presented with associations to recovery scores and time to post-anaesthesia unit discharge.
METHODS: This prospective observational cohort pilot study included 145 adult patients undergoing orthopaedic and abdominal surgery under general anaesthesia with postoperative care in the post-anaesthesia care unit at Bispebjerg Hospital, Denmark. The primary outcome was the OPIAID Zone Tool score (version 0.5). Secondary analyses assessed associations with patient-perceived health (EQ-VAS), quality of recovery (QoR-PACU) and time to discharge readiness in PACU, evaluated using R2, AIC and BIC.
RESULTS: Distribution across OPIAID Zones was broad (Zone 0: 13.8%, Zone 1: 6.9%, Zone 2: 22.1%, Zone 3: 18.6%, Zone 4: 20.0%, Zone 5: 18.6%), without clear clustering and with a tendency towards pain-dominant profiles. The OPIAID Zone Tool score was significantly associated with EQ-VAS (R2 = 0.39), QoR-PACU (R2 = 0.35) and PACU discharge readiness (R2 = 0.50), showing stronger overall associations than pain and ORADEs assessed separately.
CONCLUSION: The OPIAID Zone Tool (version 0.5) combines pain and ORADE scores into a single metric while simultaneously visualising their distribution across the population. The Zone score was associated with patient-centred outcomes and outperformed pain and ORADEs assessed separately, though a risk of overfitting cannot be ruled out. Further refinement and prospective validation are planned to optimise the tool and confirm its clinical utility.
EDITORIAL COMMENT: How high is the quality of the early postoperative analgesia that is being delivered? This study presents a model and instrument for quantifying quality of early postoperative analgesia combining treatments, pain reporting and opioid-related adverse events. The performance of the new instrument is presented with associations to recovery scores and time to post-anaesthesia unit discharge.