Preoperative predictors of moderate to intense acute postoperative pain in patients undergoing abdominal surgery
Preoperative predictors of moderate to intense acute postoperative pain in patients undergoing abdominal surgery
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DOI：
10.1034/j.1399-6576.2002.461015.x
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发表时间：
2002-11-01
影响因子：
2.1
通讯作者：
Ferreira, MBC
中科院分区：
文献类型：
--
作者：
Caumo, W;Schmidt, AP;Ferreira, MBC
背景：疼痛是一种感觉和情感体验，受生理、感觉、情感、认知、社会文化和行为因素的影响。与改善术后疼痛控制的观点一致，本研究的目的是评估术前临床因素、心理和人口特征作为报告中度至重度急性术后疼痛的预测因素的效果。方法：对 346 名接受腹部择期手术的住院患者进行前瞻性队列研究（ASA 身体状况 I-III，年龄范围 18-60 岁）。测量工具是疼痛视觉模拟量表、状态特质焦虑量表和蒙哥马利-阿斯伯格抑郁评定量表。使用多变量条件回归模型来确定中度至重度急性术后疼痛的独立预测因子。结果：中度至重度急性术后疼痛与 ASA III 状态（比值比 (OR) = 1.99）、年龄（OR = 4.72）、术前中度至重度疼痛（OR = 2.96）、慢性疼痛（OR = 1.75）、高度特质焦虑和中度至重度抑郁情绪（OR = 1.74 和 OR）相关。 = 2.00，分别）。接受癌症手术的患者报告中度至剧烈疼痛的风险较低，OR = 0.39，而接受硬膜外镇痛和全身阿片类多模式镇痛的患者（分别为 OR = 0.09 和 OR = 0.16）则较低。结论：术后剧烈急性疼痛的预测因素的识别可能有助于设计具体的预防干预措施，以减轻患者的痛苦。特别是因为这些变量中很少有可用于医疗干预的，这将改善有中度至重度急性术后疼痛风险的患者的临床结果和生活质量。
Background: Pain is a sensory and emotional experience that is influenced by physiologic, sensory, affective, cognitive, sociocultural, and behavioral factors. Consistent with the perspective to improve the postoperative pain control, the present study has the purpose of assessing the effect of presurgical clinical factors, psychological and demographic characteristics as predictors for reporting moderate to intense acute postoperative painMethods: A prospective cohort study was performed with 346 inpatients undergoing abdominal elective surgery (ASA physical status I-III, age range 18-60 years). The measuring instruments were Pain Visual Analog Scale, the State-Trait Anxiety Inventory, and the Montgomery-Asberg Depression Rating Scale. Multivariate conditional regression modeling was used to determine independent predictors for moderate to intense acute postoperative pain.Results: Moderate to intense acute postoperative pain was associated with status ASA III (odds ratio (OR) = 1.99), age (OR = 4.72), preoperative moderate to intense pain (OR = 2.96), chronic pain (OR = 1.75), high trait-anxiety and depressive mood moderate to intense (OR = 1.74 and OR = 2.00, respectively). Patients undergoing surgery to treat cancer presented lower risk for reporting moderate to intense pain OR = 0.39, as well as those that received the epidural analgesia and multimodal analgesia with systemic opioid (OR = 0.09 and OR = 0.16, respectively).Conclusions: The identification of predictive factors for intense acute postoperative pain may be useful for designing specific preventive interventions to relieve patient suffering. Especially because few of these variables are accessible for medical intervention, which would improve the clinical outcomes and quality of life of patients at risk of moderate to intense acute postoperative pain.