The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Creedmoor Psychiatric Center, Queens Village, New York City, NY, USA.
BMC Anesthesiol. 2022 Jul 4;22(1):204. doi: 10.1186/s12871-022-01740-3.
Severe pain is prevalent in cardiac surgery patients and can increase cardiac complications, morbidity and mortality. The objectives of the study were to assess perioperative pain intensity and to assess predictors of pain post-cardiac surgery, including clinical characteristics and depression.
A total of 98 cardiac surgery patients were included in the study. Pain intensity was assessed using a Numerical Rating System. Pain was measured one day pre-operatively and recorded daily from Post-operative Day 2 to Day 7. Clinical data were recorded and depression scores were assessed using the Center for Epidemiological Study of Depression (CES-D).
Pain intensity increased significantly during hospitalization from pre-operative levels, surging at 2 days post-operatively. Predictors of high pain intensity were high pre-operative CES-D scores, female gender, cardiac function, smoking and high body mass index (BMI). Significantly higher pre-operative CES-D scores were found in patients with severe pain compared to patients with no pain to moderate pain (18.23 ± 1.80 vs 12.84 ± 1.22, p = 0.01 pre-operatively). Patients with severe pain (NRS 7-10) had significantly higher levels of white blood cells (WBC) compared to patients with no pain-moderate pain (NRS 0-6), (p = 0.01). However, CES-D scores were only weakly correlated maximum WBC levels perioperatively.
Pain intensity significantly increased following surgery, and was associated with depressive symptoms, female sex, cardiac function, BMI, and smoking. These factors may serve as a basis for identification and intervention to help prevent the transition from acute pain to chronic pain.
心脏手术患者普遍存在严重疼痛，可增加心脏并发症、发病率和死亡率。本研究的目的是评估围手术期疼痛强度，并评估心脏手术后疼痛的预测因素，包括临床特征和抑郁。
共纳入 98 例心脏手术患者。使用数字评分系统评估疼痛强度。术前一天评估疼痛，并在术后第 2 天至第 7 天每天记录。记录临床数据，使用流行病学研究中心抑郁量表（CES-D）评估抑郁评分。
疼痛强度在住院期间从术前水平显著增加，术后第 2 天急剧上升。高术前 CES-D 评分、女性、心脏功能、吸烟和高体重指数（BMI）是高疼痛强度的预测因素。与无疼痛至中度疼痛的患者相比，严重疼痛（NRS 7-10）患者术前 CES-D 评分明显更高（18.23±1.80 比 12.84±1.22，p=0.01）。与无疼痛至中度疼痛（NRS 0-6）的患者相比，严重疼痛（NRS 7-10）患者的白细胞（WBC）水平明显更高（p=0.01）。然而，CES-D 评分与围手术期最大 WBC 水平仅呈弱相关。
手术后疼痛强度显著增加，与抑郁症状、女性、心脏功能、BMI 和吸烟有关。这些因素可能为识别和干预提供依据，以帮助防止急性疼痛向慢性疼痛转变。
