Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Ann Thorac Surg. 2012 Apr;93(4):1242-7. doi: 10.1016/j.athoracsur.2012.01.031. Epub 2012 Mar 6.
Pain after thoracotomy is common. The objective of this study was to assess whether pain 3 months postthoracotomy negatively impacts quality of life.
One hundred ten patients were prospectively assessed using the Medical Outcomes Study 36-Item Short Form Health Survey before and 3 months after elective thoracotomy. Pain and medication use were evaluated by questionnaire. Patients experiencing pain at 3 months were compared with patients who did not have postthoracotomy pain.
Seventy-five patients (68%) had pain 3 months postthoracotomy; 12 patients (11%) rated their average pain greater than 3 (out of 10). Eighteen (16%) patients required opioid analgesics. The pain group reported lower SF-36 scores in physical functioning (p = 0.049), bodily pain (p = 0.0002), and vitality (p = 0.044). There were no other significant differences in any SF-36 scale between the pain and non-pain groups.
Pain is commonly reported at 3 months after elective thoracotomy but is generally mild, shows improvement with time, and does not usually require opioid analgesics. Patients who experience postthoracotomy pain at 3 months are at risk for significantly decreased physical functioning and vitality, but are not at risk for significantly decreased social, emotional, or mental health functioning compared with patients who do not experience postthoracotomy pain at 3 months.
手术后疼痛是常见的。本研究的目的是评估术后 3 个月的疼痛是否对生活质量产生负面影响。
110 例择期开胸手术患者分别于术前和术后 3 个月使用医疗结局研究 36 项简明健康调查问卷进行前瞻性评估。通过问卷调查评估疼痛和药物使用情况。比较术后 3 个月有疼痛的患者和无术后疼痛的患者。
75 例患者(68%)术后 3 个月有疼痛;12 例患者(11%)平均疼痛评分大于 3(满分 10 分)。18 例(16%)患者需要阿片类镇痛药。疼痛组在生理机能(p = 0.049)、躯体疼痛(p = 0.0002)和活力(p = 0.044)方面的 SF-36 评分较低。疼痛组和无疼痛组在任何 SF-36 量表上均无其他显著差异。
择期开胸手术后 3 个月常报告疼痛,但通常较轻,随时间推移有所改善,通常不需要阿片类镇痛药。术后 3 个月有疼痛的患者在生理机能和活力方面的风险显著降低,但与术后 3 个月无疼痛的患者相比,在社会、情感或心理健康功能方面的风险无显著差异。