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肺癌切除电视辅助胸腔镜手术后疼痛强度与恢复质量的相关性

Correlation Between Pain Intensity and Quality of Recovery After Video-Assisted Thoracic Surgery for Lung Cancer Resection.

作者信息

Yoon Soo-Hyuk, Bae Jinyoung, Yoon Susie, Na Kwon Joong, Lee Ho-Jin

机构信息

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.

出版信息

J Pain Res. 2023 Oct 2;16:3343-3352. doi: 10.2147/JPR.S426570. eCollection 2023.

Abstract

PURPOSE

The Quality of Recovery-15 (QoR-15) questionnaire provides a multifaceted assessment of postoperative recovery, and the resulting score is recommended as an endpoint in clinical studies focused on postoperative pain. We aimed to investigate the correlation between the QoR-15 score and postoperative pain intensity in surgical patients.

PATIENTS AND METHODS

Adult patients who underwent video-assisted thoracoscopic surgery (VATS) for lung cancer resection and were enrolled in a prospective registry or in a previous prospective study were included in this study. Baseline and perioperative data, including the results of assessment using the Korean version of the QoR-15 (QoR-15K) questionnaire at 48 hours postoperatively, were collected from the database. Correlations between the QoR-15K total score, questionnaire dimensions, and postoperative pain intensity at 48 hours postoperatively were determined using the Spearman correlation coefficient ().

RESULTS

We analyzed a total of 137 eligible patients. Significant negative correlations were noted between the QoR-15K total score and pain intensity at rest ( = -0.45, 95% confidence interval [CI]: -0.57 - -0.31, < 0.001) and during coughing ( = -0.55, 95% CI: -0.65 - -0.42, < 0.001) at 48 hours postoperatively. The pain dimension and pain intensity at 48 hours postoperatively showed significant correlations with physical comfort, emotional state, and physical independence dimensions. Multivariable logistic regression revealed a significant negative association between the pain score at 24 hours postoperatively and good or excellent postoperative recovery.

CONCLUSION

The results support the impact of postoperative pain on the overall postoperative quality of recovery in patients who underwent VATS for lung cancer resection. Moreover, the QoR-15K score may be considered as a primary endpoint in clinical studies on postoperative pain control.

摘要

目的

术后恢复质量-15(QoR-15)问卷对术后恢复情况进行多方面评估,所得分数被推荐作为专注于术后疼痛的临床研究的一个终点指标。我们旨在调查手术患者中QoR-15评分与术后疼痛强度之间的相关性。

患者与方法

本研究纳入了接受电视辅助胸腔镜手术(VATS)进行肺癌切除术且被纳入前瞻性登记或先前前瞻性研究的成年患者。从数据库中收集基线和围手术期数据,包括术后48小时使用韩国版QoR-15(QoR-15K)问卷的评估结果。使用Spearman相关系数()确定术后48小时QoR-15K总分、问卷维度与术后疼痛强度之间的相关性。

结果

我们共分析了137例符合条件的患者。术后48小时,QoR-15K总分与静息时疼痛强度( = -0.45,95%置信区间[CI]:-0.57 - -0.31, < 0.001)以及咳嗽时疼痛强度( = -0.55,95%CI:-0.65 - -0.42, < 0.001)之间存在显著负相关。术后48小时的疼痛维度和疼痛强度与身体舒适度、情绪状态和身体独立性维度显示出显著相关性。多变量逻辑回归显示术后24小时疼痛评分与术后恢复良好或优秀之间存在显著负相关。

结论

结果支持术后疼痛对接受VATS进行肺癌切除术患者的总体术后恢复质量有影响。此外,QoR-15K评分可被视为术后疼痛控制临床研究的主要终点指标。

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