Department of Anaesthesiology, Leiden University Medical Center (LUMC), Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.
Medical Research Institute, Alexandria University, Alexandria, Egypt.
Obes Surg. 2023 Jan;33(1):204-210. doi: 10.1007/s11695-022-06354-9. Epub 2022 Nov 8.
To assess the prevalence, incidence, location, and behavior of chronic pre- and postoperative pain in bariatric surgery, and the use of analgesics.
A cross-sectional e-survey was conducted on 3928 post-bariatric patients and four-time points for pain assessment were evaluated: preoperative, on the ward, day 1 at home postoperatively, and present time (at the time of the e-survey). A numerical rating scale (NRS) was used to assess the level of pain (0 to 10). The general incidence of chronic pain was calculated, as also, subgroups were defined as group A (pre and postoperative chronic pain), B (preoperative pain, and no longer postoperative), and C (preoperative painless, postoperative chronic pain). Besides the pain intensity, location of pain, and the use of analgesics were investigated.
A total of 3279 patients (83.9%) responded to the survey. Preoperative and postoperative chronic pain was found in 343 (10.5%) and 264 (8.1%) patients, respectively. In group A, chronic pain was present in 4.8% of the patients; in group B, it was present in 5.7%; and in group C in 3.3% of the patients. Furthermore, in 4.5% of patients pain was located in the abdomen, which was higher as compared to before surgery (+ 2.3%, p < 0.001). The ORs for present postoperative chronic pain were OR 1.45, 1.7, and 1.71 (p = 0.002, 0.003, 0.003) compared to respectively preoperative chronic pain, pain at the ward, and pain at day 1 after surgery. Among all participants, 4.6% consumed chronic analgesics. Of these, paracetamol was used most frequently (3.8%), followed by tramadol (1.3%) and oxycodone (0.5%).
In this e-survey, chronic postoperative abdominal pain was prominent in patients after bariatric surgery. Of patients, 3.3% that were without preoperative chronic pain developed chronic pain after surgery. Opioid consumption in the queried population was relatively low.
评估减重手术后慢性术前和术后疼痛的患病率、发病率、部位和行为,以及镇痛药的使用情况。
对 3928 名减重手术后患者进行了横断面电子调查,并评估了 4 个时间点的疼痛评估:术前、病房、术后第 1 天在家中和当前时间(在电子调查时)。使用数字评分量表(NRS)评估疼痛程度(0 到 10)。计算慢性疼痛的总体发生率,并定义亚组为 A 组(术前和术后慢性疼痛)、B 组(术前疼痛且不再术后)和 C 组(术前无痛,术后慢性疼痛)。除了疼痛强度外,还调查了疼痛部位和镇痛药的使用情况。
共有 3279 名患者(83.9%)对调查做出了回应。术前和术后慢性疼痛分别见于 343 名(10.5%)和 264 名(8.1%)患者。在 A 组中,4.8%的患者存在慢性疼痛;在 B 组中,5.7%的患者存在慢性疼痛;在 C 组中,3.3%的患者存在慢性疼痛。此外,4.5%的患者疼痛位于腹部,高于术前(+2.3%,p<0.001)。与术前慢性疼痛、病房时疼痛和术后第 1 天疼痛相比,目前术后慢性疼痛的 OR 分别为 1.45、1.7 和 1.71(p=0.002、0.003、0.003)。在所有参与者中,4.6%的人使用慢性镇痛药。其中,最常使用的是对乙酰氨基酚(3.8%),其次是曲马多(1.3%)和羟考酮(0.5%)。
在这项电子调查中,减重手术后患者的慢性术后腹部疼痛较为突出。在没有术前慢性疼痛的患者中,有 3.3%的患者在手术后出现了慢性疼痛。在被调查人群中,阿片类药物的使用率相对较低。