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腹腔镜胃旁路手术后疼痛加剧相关因素

Factors Associated with Increased Experience of Postoperative Pain after Laparoscopic Gastric Bypass Surgery.

作者信息

Hartwig Markus, Allvin Renée, Bäckström Ragnar, Stenberg Erik

机构信息

Department of Anaesthesiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

Department of Anaesthesiology and Intensive care, Örebro University Hospital, Örebro, Sweden.

出版信息

Obes Surg. 2017 Jul;27(7):1854-1858. doi: 10.1007/s11695-017-2570-4.

Abstract

INTRODUCTION

Patients with high body mass index (BMI), pre-existing pain and young age and women seem to experience more postoperative pain. Few studies have, however, addressed these risk factors amongst obese patients undergoing bariatric surgery. The aim of the present study was to evaluate risk factors for postoperative pain following laparoscopic gastric bypass surgery.

METHODS

In this cohort study, we used data from the PAIN OUT register for postoperative pain during the first 24 h after surgery. Primary outcome measure was severity of pain after surgery. Multivariate analyses were conducted to evaluate BMI, young age, gender and pre-existing pain as independent risk factors for postoperative pain.

RESULTS

We included 192 patients in this study. Younger age (B -0.08, 95%CI -0.11 to -0.05/year; p < 0.001), female gender (B 0.92, 95%CI 0.10-1.75; p = 0.029) and pre-existing pain (B 1.06, 95%CI 0.03-2.09; p = 0.044) were all associated with an increased risk for postoperative pain. In the multivariate analyses, only young age ((adjusted OR 0.95, 95%CI 0.92-0.97/year; p < 0.001) and pre-existing pain (adjusted OR 2.56, 95%CI 1.09-6.00; p = 0.031) remained as independent risk factors for severe postoperative pain.

CONCLUSION

Younger age and pre-existing pain are associated with severe postoperative pain during the first 24 h after laparoscopic gastric bypass surgery, whereas female gender and high BMI are not.

摘要

引言

高体重指数(BMI)、既往有疼痛、年轻以及女性患者似乎术后疼痛更明显。然而,很少有研究探讨接受减肥手术的肥胖患者中的这些危险因素。本研究的目的是评估腹腔镜胃旁路手术后疼痛的危险因素。

方法

在这项队列研究中,我们使用了PAIN OUT登记册中关于术后24小时内术后疼痛的数据。主要结局指标是术后疼痛的严重程度。进行多变量分析以评估BMI、年轻、性别和既往疼痛作为术后疼痛的独立危险因素。

结果

本研究纳入了192例患者。年龄较小(B -0.08,95%CI -0.11至-0.05/年;p <0.001)、女性(B 0.92,95%CI 0.10 - 1.75;p = 0.029)和既往有疼痛(B 1.06,95%CI 0.03 - 2.09;p = 0.044)均与术后疼痛风险增加相关。在多变量分析中,只有年龄较小(调整后的OR 0.95,95%CI 0.92 - 0.97/年;p <0.001)和既往有疼痛(调整后的OR 2.56,95%CI 1.09 - 6.00;p = 0.031)仍然是严重术后疼痛的独立危险因素。

结论

年龄较小和既往有疼痛与腹腔镜胃旁路手术后24小时内的严重术后疼痛相关,而女性和高BMI则不然。

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