Choi Seungeun, Yoon Soo-Hyuk, Lee Ho-Jin
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Korean J Pain. 2024 Jul 1;37(3):188-200. doi: 10.3344/kjp.24069.
This review explores the essential methodologies for effective postoperative pain management, focusing on the need for thorough pain assessment tools, as underscored in various existing guidelines. Herein, the strengths and weaknesses of commonly used pain scales for postoperative pain-the Visual Analog Scale, Numeric Rating Scale, Verbal Rating Scale, and Faces Pain Scale-are evaluated, highlighting the importance of selecting appropriate assessment tools based on factors influencing their effectiveness in surgical contexts. By emphasizing the need to comprehend the minimal clinically important difference (MCID) for these scales in evaluating new analgesic interventions and monitoring pain trajectories over time, this review advocates recognizing the limitations of common pain scales to improve pain assessment strategies, ultimately enhancing postoperative pain management. Finally, five recommendations for pain assessment in research on postoperative pain are provided: first, selecting an appropriate pain scale tailored to the patient group, considering the strengths and weaknesses of each scale; second, simultaneously assessing the intensity of postoperative pain at rest and during movement; third, conducting evaluations at specific time points and monitoring trends over time; fourth, extending the focus beyond the intensity of postoperative pain to include its impact on postoperative functional recovery; and lastly, interpreting the findings while considering the MCID, ensuring that it is clinically significant for the chosen pain scale. These recommendations broaden our understanding of postoperative pain and provide insights that contribute to more effective pain management strategies, thereby enhancing patient care outcomes.
本综述探讨了有效进行术后疼痛管理的基本方法,重点关注各种现有指南中所强调的对全面疼痛评估工具的需求。在此,对术后疼痛常用疼痛量表——视觉模拟量表、数字评定量表、语言评定量表和面部疼痛量表的优缺点进行了评估,强调了根据影响其在手术环境中有效性的因素选择合适评估工具的重要性。通过强调在评估新的镇痛干预措施和长期监测疼痛轨迹时理解这些量表的最小临床重要差异(MCID)的必要性,本综述主张认识到常用疼痛量表的局限性,以改进疼痛评估策略,最终加强术后疼痛管理。最后,提供了术后疼痛研究中疼痛评估的五项建议:第一,根据患者群体选择合适的疼痛量表,考虑每种量表的优缺点;第二,同时评估静息和运动时的术后疼痛强度;第三,在特定时间点进行评估并随时间监测趋势;第四,将关注点从术后疼痛强度扩展到包括其对术后功能恢复的影响;最后,在考虑MCID的同时解释研究结果,确保其对所选疼痛量表具有临床意义。这些建议拓宽了我们对术后疼痛的理解,并提供了有助于制定更有效疼痛管理策略的见解,从而改善患者护理结果。