Zhang Yujiao, Xia Yangyang, Yong Yue, Zhou Yalan, Yin Zhiyu, Wang Jing, Mei Ling, Song Wei, Wang Jian, Song Jiangang
Department of Anesthesiology, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
Research Institute of Acupuncture Anesthesia, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
J Pers Med. 2023 Mar 15;13(3):528. doi: 10.3390/jpm13030528.
The evolution of pain after anorectal surgery has not been well characterized. The main objective of this study is to evaluate patterns in acute postoperative pain in patients undergoing short-stay anorectal surgery. A total of 217 patients were included in the study, which used group-based trajectory modeling to estimate postoperative pain and then examined the relationships between sociodemographic or surgical factors and pain trajectories. Three distinct postoperative pain trajectories were determined: hemorrhoidectomy (OR, 0.15), higher anxiety (OR, 3.26), and a higher preoperative pain behavior score (OR, 3.15). In multivariate analysis, they were associated with an increased likelihood of being on the high pain trajectory. The pain trajectory group was related to postoperative analgesic use ( < 0.001), with the high-low group needing more nonsteroidal analgesics. The study showed that there were three obvious pain trajectories after anorectal surgery, including an unreported low-moderate-low type. More than 60% of patients maintained moderate to severe pain within 7 days after the operation. These postoperative pain trajectories were predominantly defined by surgery factors and patient factors.
肛肠手术后疼痛的演变尚未得到充分描述。本研究的主要目的是评估接受短期住院肛肠手术患者的急性术后疼痛模式。共有217名患者纳入本研究,该研究采用基于组的轨迹模型来估计术后疼痛,然后检查社会人口统计学或手术因素与疼痛轨迹之间的关系。确定了三种不同的术后疼痛轨迹:痔切除术(比值比,0.15)、较高焦虑水平(比值比,3.26)和较高的术前疼痛行为评分(比值比,3.15)。在多变量分析中,它们与处于高疼痛轨迹的可能性增加相关。疼痛轨迹组与术后镇痛药物使用有关(<0.001),高-低组需要更多的非甾体类镇痛药。该研究表明,肛肠手术后有三种明显的疼痛轨迹,包括一种未报告的低-中-低类型。超过60%的患者在术后7天内维持中度至重度疼痛。这些术后疼痛轨迹主要由手术因素和患者因素决定。
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