Abstract
Background Several predictors have been shown to be independently associated with chronic postsurgical pain for gastrointestinal surgery, but few studies have investigated the factors associated with acute postsurgical pain (APSP). The aim of this study was to identify the predictors of APSP intensity and severity through investigating demographic, psychological, and clinical variables. Methods We performed a prospective cohort study of 282 patients undergoing gastrointestinal surgery to analyze the predictors of APSP. Psychological questionnaires were assessed 1 day before surgery. Meanwhile, demographic characteristics and perioperative data were collected. The primary outcomes are APSP intensity assessed by numeric rating scale (NRS) and APSP severity defined as a clinically meaningful pain when NRS ≥4. The predictors for APSP intensity and severity were determined using multiple linear regression and multivariate logistic regression, respectively. Results 112 patients (39.7%) reported a clinically meaningful pain during the first 24 hours postoperatively. Oral morphine milligram equivalent (MME) consumption (β 0.05, 95% CI 0.03–0.07, p < 0.001), preoperative anxiety (β 0.12, 95% CI 0.08–0.15, p < 0.001), and expected postsurgical pain intensity (β 0.12, 95% CI 0.06–0.18, p < 0.001) were positively associated with APSP intensity. Furthermore, MME consumption (OR 1.15, 95% CI 1.10–1.21, p < 0.001), preoperative anxiety (OR 1.33, 95% CI 1.21–1.46, p < 0.001), and expected postsurgical pain intensity (OR 1.36, 95% CI 1.17–1.57, p < 0.001) were independently associated with APSP severity. Conclusion These results suggested that the predictors for APSP intensity following gastrointestinal surgery included analgesic consumption, preoperative anxiety, and expected postsurgical pain, which were also the risk factors for APSP severity.
Highlights
Acute postsurgical pain (APSP) is defined as pain within the first 24 hours postoperatively
Risk Factors for Postsurgical Pain Severity. 169 patients reported absence of pain or mild pain (NRS ≤3) on acute postsurgical pain (APSP) severity, whereas 113 patients reported moderate-to-severe pain, regarded as clinically meaningful pain. e univariate logistic analysis showed that APSP severity was significantly correlated with milligram equivalent (MME) consumption, preoperative anxiety, preoperative depression, and expected postsurgical pain
We found that preoperative anxiety was significantly correlated with APSP intensity and became an independent predictor of APSP intensity and severity. ese results are consistent with studies which suggested that presurgical anxiety can predict APSP intensity for hysterectomy [7], cesarean [9], inguinal hernioplasty [10], knee replacement [11], and breast cancer surgery [12,13,14]
Summary
Acute postsurgical pain (APSP) is defined as pain within the first 24 hours postoperatively. Moderate or severe APSP is reported in 10% to 57% of patients undergoing various types of surgeries [1]. Several predictors have been shown to be independently associated with chronic postsurgical pain for gastrointestinal surgery, but few studies have investigated the factors associated with acute postsurgical pain (APSP). E aim of this study was to identify the predictors of APSP intensity and severity through investigating demographic, psychological, and clinical variables. MME consumption (OR 1.15, 95% CI 1.10–1.21, p < 0.001), preoperative anxiety (OR 1.33, 95% CI 1.21–1.46, p < 0.001), and expected postsurgical pain intensity (OR 1.36, 95% CI 1.17–1.57, p < 0.001) were independently associated with APSP severity. Ese results suggested that the predictors for APSP intensity following gastrointestinal surgery included analgesic consumption, preoperative anxiety, and expected postsurgical pain, which were the risk factors for APSP severity Conclusion. ese results suggested that the predictors for APSP intensity following gastrointestinal surgery included analgesic consumption, preoperative anxiety, and expected postsurgical pain, which were the risk factors for APSP severity
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