Abstract
Moderate-severe pain after surgical procedures is associated with decreased quality of life and increased costs. This study aimed to identify the incidence and predictive factors of moderate-severe postoperative pain within 48 hours following video-assisted thoracoscopic surgery (VATS) in a tertiary hospital. A retrospective cohort analysis was performed using medical records of adult patients who underwent VATS between January 2015 and December 2016. Logistic regression was performed to identify predictive factors for moderate-severe pain (visual analogue scale, VAS ≥ 4) within 24 hours and within 48 hours postoperatively. Of the 1164 participants, the incidence of moderate-severe pain was 12.7% within the first 24 hours and 15.6% within the first 48 hours after surgery. In multivariable analysis, the independent risk factors related to moderate-severe pain within 24 hours after surgery were younger age, increased body mass index, preoperative pain within 1 month and history of smoking. The risk factors for moderate-severe acute pain within 48 hours were almost the same, except that the number of chest tubes were also included. Moderate-severe postoperative pain following VATS is not rare, and presence of several risk factors deserves more aggressive pain management strategies perioperatively.
Highlights
Moderate-severe pain after surgical procedures is associated with prolonged hospital stays, readmissions, patient dissatisfaction, development of chronic pain, decreased quality of life and increased costs[1,2]
The independent risk factors related to moderate-severe pain within 24 hours after surgery were younger age (OR, 0.96; 95% confidence interval (CI), 0.95 to 0.98, P < 0.001), increased BMI (OR, 1.10; 95% CI, 1.04 to 1.16, P = 0.001), preoperative existing pain within 1 month (OR, 1.55; 95% CI, 1.01 to 2.39, P = 0.044) and smoking history (OR, 1.86; 95% CI, 1.29 to 2.70, P = 0.001)
This large retrospective cohort study revealed that 15.6% of patients suffered from moderate-severe pain over 48 hours after Video assisted thoracoscopic surgery (VATS)
Summary
Moderate-severe pain after surgical procedures is associated with prolonged hospital stays, readmissions, patient dissatisfaction, development of chronic pain, decreased quality of life and increased costs[1,2]. Potentially less postoperative pain was generally expected as one of the benefits of VATS4, many patients still suffer moderate to severe pain postoperatively[2,5,6,7]. There are several reasons contributing to this unsatisfactory situation, one of them being that some patients may have certain risk factors for occurrence of more severe postoperative pain[8]. The predictive factors of moderate-severe postoperative pain following VATS were not reported, which is important for individual-specific pain management perioperatively. This study was conducted to investigate the incidence and risk factors of moderate-severe postoperative pain over the first 48 hours following VATS in a tertiary hospital
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