Pain location, distribution, and intensity after cardiac surgery
Pain location, distribution, and intensity after cardiac surgery
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DOI：
10.1378/chest.118.2.391
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发表时间：
2000-08-01
期刊：
影响因子：
9.6
通讯作者：
von Segesser, LK
中科院分区：
文献类型：
--
作者：
Mueller, XM;Tinguely, F;von Segesser, LK
研究目的：研究成人心脏手术患者术后住院期间疼痛的位置、分布和强度。设计：在前瞻性研究中，记录术后第1天、第2天、第3天和第7天的疼痛位置、分布(每个患者的疼痛区域数量)和疼痛强度(0到10个数值评分标准)。分析患者特征(年龄、性别、大小和体重指数)对疼痛强度的影响。单位：一所大学医院。患者：200名连续接受胸骨正中切开心脏直视手术的成年患者。男性121例，女性79例，平均年龄(+/-SD)60.9+/-19.2岁。测量和结果：最大疼痛强度在第1天和第2天显著高于第2天(分别为3.7±-2和3.9±1.9)，在第3天和第7天较低(分别为3.2+/-1.5和2.6+/-1.8)。在整个住院期间，疼痛的分布没有显著差异，但部位有差异，在POD 7时肩部疼痛较多。只有年龄对疼痛强度有影响，60岁的患者在POD 2时的疼痛强度高于老年患者(4.3+/-2.2vs3.6+/-2.4；P=0.02)。结论：在该患者群体中，疼痛强度从POD 3开始减弱，尽管其分布在术后1周内没有显著变化。此外，疼痛部位随着时间的推移而变化，术后第一周的骨关节类型疼痛较多。在患者的特征中，只有较年轻的年龄对疼痛强度有影响，POD 2的值较高。
Study objectives: To study the location, distribution, and intensity of pain in a sample of adult cardiac surgery patients during their postoperative hospital stay.Design: In a prospective study, pain location, distribution (number of pain areas per patient), and intensity (0 to 10 numerical rating scale) were documented on the first, second, third, and seventh postoperative day (POD). Patient characteristics (age, sex, size, and body mass index) were analyzed for their impact on pain intensity.Setting: A university hospital.Patients: Two hundred consecutive adult patients who underwent median sternotomy for open heart surgery. There were 121 male and 79 female patients, with a mean (+/- SD) age of 60.9 +/- 19.2 years.Measurement and results: The maximal pain intensity was significantly higher on POD 1 and 2 (3.7 +/- 2 and 3.9 +/- 1.9, respectively) and lower on POD 3 and 7 (3.2 +/- 1.5 and 2.6 +/- 1.8, respectively). The pain distribution did not vary significantly throughout the hospital stay, but the location did, with more shoulder pain on POD 7. Only age was found to have an impact on pain intensity, with patients < 60 years having a higher pain intensity than older patients on POD 2 (4.3 +/- 2.2 vs 3.6 +/- 2.4; p = 0.02).Conclusions: In this patient population, the pain intensity diminished from POD 3 onward, although its distribution did not vary significantly during the first postoperative week. Moreover, pain location changed with time, with more osteoarticular type pain at the end of the first postoperative week. Among the patients' characteristics, only younger age had an impact on pain intensity, with a higher value on POD 2.