Department of Anaesthesiology and Pain Treatment, University Hospital Maastricht, 6202 AZ Maastricht, The Netherlands.
Clin J Pain. 2010 Feb;26(2):87-94. doi: 10.1097/AJP.0b013e3181b43d68.
Objectives:Despite efforts to improve acute postoperative pain management, a substantial number of patients still experience moderate to severe pain during the immediate postoperative days. The purpose of the present study was to identify predictors of moderate to severe acute postoperative pain.
Methods: A total of 1490 patients undergoing heterogeneous surgical procedures recorded their pain 3 times a day on a 100-mm visual analog scale from the day before the operation until 5 days postoperation. For each postoperative day, pain intensity was classified as moderate when the mean pain score was 41 to 74mm and as "severe when the mean pain score was 75 to 100 mm. Using logistic regression analyses, we examined the predictive value of a comprehensive set of preoperative and perioperative variables for moderate to severe pain.
Results: The most important predictors seemed to be; preoperative pain, expected pain, surgical fear, and pain catastrophizing.
Discussion: Several predictive factors of postoperative pain were identified in this study. These factors could be taken into account in postoperative pain management.
目的:尽管已经努力改善急性术后疼痛管理,但仍有相当数量的患者在术后即刻出现中度至重度疼痛。本研究的目的是确定中度至重度急性术后疼痛的预测因素。
方法:共有 1490 名接受不同手术的患者在手术前一天至术后 5 天期间,每天 3 次使用 100mm 视觉模拟量表记录他们的疼痛情况。对于每个术后日,如果平均疼痛评分在 41 至 74mm 之间,则将疼痛强度分类为中度,如果平均疼痛评分在 75 至 100mm 之间,则将疼痛强度分类为“重度”。我们使用逻辑回归分析,检查了一整套术前和围手术期变量对中度至重度疼痛的预测价值。
结果:最重要的预测因素似乎是:术前疼痛、预期疼痛、手术恐惧和疼痛灾难化。
讨论:本研究确定了几个术后疼痛的预测因素。这些因素可以在术后疼痛管理中考虑。