Analysis of the trajectory of acute pain after median thoracotomy cardiac and its influencing factors
10.3760/cma.j.cn115682-20221128-05729
- VernacularTitle:正中开胸心脏手术患者术后急性疼痛发展轨迹及其影响因素分析
- Author:
Xiang ZHANG
1
;
Yuping LIU
;
Yuan NING
Author Information
1. 徐州医科大学护理学院，徐州 221004
- Keywords:
Cardiac surgery;
Pain;
Postoperative;
Median thoracotomy;
Trajectory;
Cohort study
- From:
Chinese Journal of Modern Nursing
2023;29(12):1563-1569
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the trajectory of acute pain after median thoracotomy surgery, and analyze its influencing factors, so as to provide guidance for pain management after cardiac surgery.Methods:In this prospective cohort study, a total of 255 patients who underwent median thoracotomy in the Cardiac Surgery Department of the Affiliated Hospital of Xuzhou Medical University from September 2021 to May 2022 were selected by convenience sampling and investigated with the general data questionnaire, Hospital Anxiety Scale (HAS), Hospital Depression Scale (HDS) and Pain Catastrophizing Scale (PCS). The pain degree of patients 1 to 7 days after operation was assessed by digital evaluation tools. The Group-Based Trajectory Model was used to describe the trajectory of postoperative pain, and multivariate Logistic regression was used to analyze the influencing factors of pain trajectory categories.Results:Due to reasons such as death and refusal to further investigation, 210 patients finally completed the 7-day follow-up. Three postoperative pain trajectory categories were identified, namely, moderate to mild pain-significant relief group ( n=75), severe to moderate pain-slow relief group ( n=99) and persistent severe pain group ( n=36). The results of univariate analysis showed that sex, age, body mass index, number of postoperative drainage tubes, indwelling time of drainage tube, operation time, HAS score, HDS score, and PCS score were the influencing factors of acute pain trajectory categories ( P<0.05). Taking the moderate to mild pain-significant relief group as a reference, the results of multivariate Logistic regression analysis showed that sex, age, body mass index, indwelling time of drainage tube, HAS score, HDS score, and PCS score were the independent influencing factors of the postoperative acute pain trajectory of this patient group ( P<0.05) . Conclusions:The trajectories of postoperative acute pain in patients undergoing median thoracotomy are heterogeneous. Medical and nursing staff should pay full attention to patients who are female, young, obese, have long indwelling time of drainage tubes, preoperative anxiety, preoperative depression, and high PCS scores. It is necessary to improve the quality of pain management in postcardiac surgery patients through appropriate targeted interventions.
