Shatkin-Margolis Abigail, Crisp Catrina C, Morrison Christopher, Pauls Rachel N
Female Pelvic Med Reconstr Surg. 2018 Mar/Apr;24(2):172-175. doi: 10.1097/SPV.0000000000000522.
An ability to anticipate individuals at increased risk of postoperative pain would improve coordination of care and patient satisfaction. We sought to describe predictive factors of postoperative pain following vaginal reconstructive surgery.
This institutional review board-approved, retrospective study used previously collected data from research performed at 1 center from 2009 to 2015. Eligible trials enrolled subjects undergoing vaginal reconstructive surgery for pelvic organ prolapse. All studies used a validated visual analog scale (VAS) for pain on postoperative day 1. Other information collected included pain medication use, medical and surgical history, and demographics. Linear regression analyses, multiple regression analyses, Mann-Whitney U, and Kruskal-Wallis tests were used to analyze the relationship between VAS scores and other variables.
Six studies were analyzed with a total of 364 patients. The median age was 60 years (interquartile range, 16 years), and the median pain score on postoperative day 1 was 35 mm on a 100-mm VAS. Patients younger than 60 years (P < 0.001), those who used tobacco (P = 0.014), those who used pain medication prior to surgery (P = 0.007), and those who did not have a concomitant midurethral sling (P = 0.018) had significantly higher pain scores postoperatively. A trend was also noted with operating times greater than 210 minutes (P = 0.057) and preexisting history of depression (P = 0.065). Multiple regression was performed, and age, depression, tobacco use, and concomitant sling were found to be independent factors predictive of postoperative pain scores.
Age, depression, tobacco use, and concomitant midurethral sling are significant independent factors predictive of postoperative pain following vaginal reconstructive surgery.
能够预测术后疼痛风险增加的个体，将改善护理协调和患者满意度。我们试图描述阴道重建手术后疼痛的预测因素。
这项经机构审查委员会批准的回顾性研究使用了2009年至2015年在1个中心进行的研究中预先收集的数据。符合条件的试验纳入了因盆腔器官脱垂接受阴道重建手术的受试者。所有研究均使用经过验证的视觉模拟量表（VAS）评估术后第1天的疼痛情况。收集的其他信息包括止痛药物使用情况、病史和手术史以及人口统计学信息。采用线性回归分析、多元回归分析、曼-惠特尼U检验和克鲁斯卡尔-沃利斯检验来分析VAS评分与其他变量之间的关系。
对6项研究进行了分析，共纳入364例患者。中位年龄为60岁（四分位间距为16岁），术后第1天的中位疼痛评分在100mm VAS上为35mm。年龄小于60岁的患者（P<0.001）、吸烟患者（P = 0.014）、术前使用止痛药物的患者（P = 0.007）以及未同时进行尿道中段吊带术的患者（P = 0.018）术后疼痛评分显著更高。手术时间大于210分钟（P = 0.057）和既往有抑郁症病史（P = 0.065）也观察到有这种趋势。进行了多元回归分析，发现年龄、抑郁症、吸烟和同时进行吊带术是术后疼痛评分的独立预测因素。
年龄、抑郁症、吸烟和同时进行尿道中段吊带术是阴道重建手术后疼痛的重要独立预测因素。
