Bjørnnes Ann Kristin, Lie Irene, Parry Monica, Falk Ragnhild, Leegaard Marit, Rustøen Tone, Valeberg Berit Taraldsen
Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway,
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada,
J Pain Res. 2018 Aug 1;11:1425-1432. doi: 10.2147/JPR.S167524. eCollection 2018.
Cardiac surgical pain remains a clinical challenge affecting about 40% of individuals in the first six months post-cardiac surgery, and continues up to two years after surgery for about 15-20%. Self-perceived sensitivity to pain may help to identify individuals at risk for persistent cardiac surgical pain to optimize health care responses. The purpose of this study was to assess the relationship between self-perceived pain sensitivity assessed by the Pain Sensitivity Questionnaire (PSQ) and postoperative worst pain intensity up to 12 months after cardiac surgery. Sex differences in baseline characteristics and the PSQ scores were also assessed.
This study was performed among 416 individuals (23% women) scheduled for elective coronary artery bypass graft and/or valve surgery between March 2012 and September 2013. A secondary data-analysis was utilized to explore the relationship between preoperative PSQ scores and worst pain intensity rated preoperatively, across postoperative Days 1-4, at 2 weeks, and at 1, 3, 6, and 12 months post-surgery. Linear mixed model analyses were performed to estimate changes in pain intensity during 1-year follow-up.
The mean (±standard deviation) PSQ-total score was 3.3±1.4, with similar scores in men and women. The PSQ-total score was significantly associated with higher worst pain intensity ratings adjusted for participant characteristics (=0.001).
Use of the PSQ before surgery may predict cardiac surgical pain intensity. However, previous evidence is limited and not consistent, and more research is needed to substantiate our results.
心脏外科手术后的疼痛仍是一项临床挑战，约40%的患者在心脏手术后的头六个月会受到影响，约15%-20%的患者术后两年仍持续疼痛。自我感知的疼痛敏感性可能有助于识别有持续性心脏外科手术疼痛风险的个体，以优化医疗应对措施。本研究的目的是评估通过疼痛敏感性问卷（PSQ）评估的自我感知疼痛敏感性与心脏手术后长达12个月的术后最严重疼痛强度之间的关系。还评估了基线特征和PSQ评分中的性别差异。
本研究在2012年3月至2013年9月期间计划进行择期冠状动脉搭桥术和/或瓣膜手术的416名个体（23%为女性）中进行。利用二次数据分析来探讨术前PSQ评分与术前、术后第1-4天、2周、1、3、6和12个月时评定的最严重疼痛强度之间的关系。进行线性混合模型分析以估计1年随访期间疼痛强度的变化。
PSQ总分的平均值（±标准差）为3.3±1.4，男性和女性的得分相似。在根据参与者特征进行调整后，PSQ总分与更高的最严重疼痛强度评分显著相关（=0.001）。
术前使用PSQ可能预测心脏外科手术的疼痛强度。然而，先前的证据有限且不一致，需要更多研究来证实我们的结果。
