Incidence and Risk Factors for Acute Postoperative Pain in Patients With Lung Cancer.

OBJECTIVE

To analyze the current incidence of acute postoperative pain (APSP) and the associated risk factors to enrich multimodal analgesic regimens and provide the basis for more personalized and precise management of postoperative pain in patients with lung cancer.

METHODS

This was a prospective case-control study. A sequential sampling method was used to enroll patients with lung cancer in the thoracic surgery department of a general hospital in Sichuan Province. The demographic data, perioperative psychological state, quality of sleep, and pain perception of patients were collected via questionnaires such as the Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and Pain Catastrophizing Scale (PCS). The VonFery mechanical stimulation kit was used to complete the Quantitative Sensory Testing (QST); and surgery-related information was collected through medical records. Postoperative pain was assessed at 12, 24, 36, 48, 60, and 72 hours after surgery. The study participants were grouped by the presence of moderate or severe pain (Numeric Rating Scale, NRS ≥ 4) after surgery, and the risk factors for APSP in patients with lung cancer were analyzed via univariate analysis and binary logistic regression analysis.

RESULTS

A total of 200 adult patients with lung cancer were recruited for this study, including 89 males (44.5%) and 111 females (55.5%). The average age was 55.91 ± 10.42 years, and the average BMI was 23.17 ± 2.81 kg/m2. All patients were divided into the APSP group (n = 59) and NOAPSP group (n = 140) according to whether they experienced acute postoperative pain (NRS ≥ 4), so the incidence of APSP was 29.5%. Binary logistic regression analysis revealed that the independent risk factors for APSP included sex, drinking history, preoperative pain score, preoperative anxiety, and surgical history.

CONCLUSION

Female sex, drinking history, surgical history, preoperative pain, and preoperative anxiety were independent risk factors for poor postoperative pain control. These findings suggest that health care providers should actively consider the control of the above factors and take preventive measures against risk factors when implementing multimodal and individualized analgesia. For example, diverse methods for providing analgesia, controlling preoperative pain and providing perioperative mental care and cognitive therapy to patients with different characteristics have been developed.