Liu Qing-Ren, Dai Yu-Chen, Ji Mu-Huo, Liu Pan-Miao, Dong Yong-Yan, Yang Jian-Jun
Department of Anesthesiology, Xishan People's Hospital of Wuxi City, Wuxi, 214105, People's Republic of China.
Department of Anesthesiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, 210009, People's Republic of China.
J Pain Res. 2024 May 20;17:1793-1804. doi: 10.2147/JPR.S462112. eCollection 2024.
Acute postsurgical pain (APSP) has received growing attention as a surgical outcome. When poorly controlled, APSP can affect short- and long-term outcomes in patients. Despite the steady increase in awareness about postoperative pain and standardization of pain prevention and treatment strategies, moderate-to-severe APSP is frequently reported in clinical practice. This is possibly because pain varies widely among individuals and is influenced by distinct factors, such as demographic, perioperative, psychological, and genetic factors. This review investigates the risk factors for APSP, including gender, age, obesity, smoking history, preoperative pain history, pain sensitivity, preoperative anxiety, depression, pain catastrophizing, expected postoperative pain, surgical fear, and genetic polymorphisms. By identifying patients having an increased risk of moderate-to-severe APSP at an early stage, clinicians can more effectively manage individualized analgesic treatment protocols with a combination of pharmacological and non-pharmacological interventions. This would alleviate the transition from APSP to chronic pain and reduce the severity of APSP-induced chronic physical disability and social psychological distress.
急性术后疼痛（APSP）作为一种手术结局受到越来越多的关注。如果控制不佳，APSP会影响患者的短期和长期预后。尽管人们对术后疼痛的认识不断提高，且疼痛预防和治疗策略也日益标准化，但临床实践中仍经常报告中重度APSP。这可能是因为疼痛在个体间差异很大，并受到多种不同因素的影响，如人口统计学、围手术期、心理和遗传因素等。本综述调查了APSP的危险因素，包括性别、年龄、肥胖、吸烟史、术前疼痛史、疼痛敏感性、术前焦虑、抑郁、灾难化思维、预期术后疼痛、手术恐惧和基因多态性。通过在早期识别出中重度APSP风险增加的患者，临床医生可以更有效地采用药物和非药物干预相结合的方式，管理个性化镇痛治疗方案。这将缓解APSP向慢性疼痛的转变，并减轻APSP所致慢性身体残疾和社会心理困扰的严重程度。
