Aykut Aslıhan, Salman Nevriye, Demir Zeliha Aslı, Eser Atakan Furkan, Özgök Ayşegül, Günaydın Serdar
University of Health Sciences Turkey, Ankara Bilkent City Hospital, Clinic of Anaesthesiology and Reanimation, Ankara, Turkey.
University of Health Sciences Turkey, Ankara Bilkent City Hospital, Clinic of Cardiovascular Surgery, Ankara, Turkey.
Turk J Anaesthesiol Reanim. 2023 Dec 27;51(6):491-495. doi: 10.4274/TJAR.2023.231477.
Perioperative multimodal analgesia is an important step in enhanced recovery after surgery (ERAS) care. Many factors, such as preoperative chronic pain and anxiety, may provide information about the expected postoperative pain. In this study, we evaluated preoperative pain and anxiety and investigate their effects on acute postoperative pain in patients undergoing elective cardiac surgery.
After ethics committee approval, 67 consenting patients undergoing on-pump cardiac surgery under the ERAS program were included in our prospective observational study. Pre- and postoperative pain scores were obtained using a numeric rating scale (NRS) at rest and during movement. Preoperative anxiety was assessed on a 0-10 scale, and data were recorded. The relationships between pre-operative pain/anxiety and postoperative pain were evaluated using correlation analysis.
In preoperative pain assessment, the percentage of patients with a pain score above 4 with NRS was 1.5%, regardless of whether they were at rest or mobilize. In postoperative pain assessment, there were 20.9% and 34.3% patients with NRS >4 at rest and mobilization, respectively. 7.5% of patients had preoperative anxiety of grade 5 or higher. While preoperative pain was not correlated with postoperative pain, preoperative anxiety had a moderate positive correlation with postoperative pain (r=0.382, =0.003).
The prevalence of preoperative pain in patients who underwent cardiac surgery is quite low and is not associated with postoperative pain. There is also a significant relationship between the severity of preoperative anxiety and postoperative pain.
围手术期多模式镇痛是术后加速康复（ERAS）护理的重要环节。许多因素，如术前慢性疼痛和焦虑，可能为术后预期疼痛提供信息。在本研究中，我们评估了术前疼痛和焦虑，并调查它们对择期心脏手术患者术后急性疼痛的影响。
经伦理委员会批准，67例在ERAS计划下接受体外循环心脏手术且同意参与的患者纳入我们的前瞻性观察研究。术前和术后疼痛评分采用静息和活动时的数字评分量表（NRS）获得。术前焦虑采用0 - 10分制进行评估，并记录数据。采用相关性分析评估术前疼痛/焦虑与术后疼痛之间的关系。
在术前疼痛评估中，无论静息还是活动时，NRS疼痛评分高于4分的患者百分比为1.5%。在术后疼痛评估中，静息和活动时NRS>4分的患者分别为20.9%和34.3%。7.5%的患者术前焦虑为5级或更高。虽然术前疼痛与术后疼痛无相关性，但术前焦虑与术后疼痛呈中度正相关（r = 0.382，P = 0.003）。
接受心脏手术患者的术前疼痛发生率相当低，且与术后疼痛无关。术前焦虑严重程度与术后疼痛之间也存在显著关系。
