Construction of Pain Management Strategies After Hepatectomy: Evidence Summary and Delphi Study

Purpose: To develop and summarize pain management strategies after hepatectomy for liver cancer based on the best evidence summary, and to improve the strategy of the Delphi study.

Methods: According to the "6S" evidence pyramid model, the database was systematically searched, with a search deadline of December 2023. Two researchers independently conducted literature screening and quality evaluation. Relevant evidence on pain management was extracted and integrated. Relevant evidence for pain management formed a preliminary strategy through a one-day, face-to-face meeting. Subsequently, a Delphi process was performed to improve the strategy. The scientific soundness of the Delphi method was expressed by the effective response rate, authority coefficient (Cr), and coordination coefficient. The coordination of expert opinions was assessed using the coefficient of variation (CV) and Kendall's coefficient (W). Cr should be above 0.700 and the coefficient of variation (CV) should be below 0.25. Data analysis was performed using SPSS V.25.0.

Results: A total of 14 studies were included, and we summarized 13 first-level items and 48 second-level items by two rounds of Delphi. The effective response rate of the two rounds of Delphi was 100.00%, and the authority coefficient of the experts was 0.832. The coefficients of variation were 0.00-0.41 and 0.05-0.17, respectively. The Kendall's W values for the two rounds were 0.114-0.222 (p<0.05).

Conclusion: Pain management strategy after hepatectomy is scientific and applicable. We plan to translate this into a plan and confirm its feasibility in the future.