The Incidence Rate And Risk Factors Of Chronic Pain Following Thoracic Surgery

ObjectiveAt present,there are few targeted studies,and domestic research is less than foreign studies on chronic pain after thoracic surgery(thoracotomy and thoracoscopy).The ample sizes of some studies are small,and predictors such as anxiety and age are not refined on chronic post-surgical pain.In response to these phenomena,the purpose of this study was to discuss the incidence and the risk factors of chronic pain after thoracic surgery.MethodsIn this study,a total of 378 patients undergoing elective operation of thoracic surgery in Shandong Chest Hospital during December 2015 to December 2017 were selected.The influencing factors of chronic post-surgical pain were predicted by means of clinical observation and the explored literatures.Later,carry out focused and planned interviews,observation,measurement,classification and recording for patients.Visit patients in time before operation,and interview carefully,verify objectively,record in detail and classify reasonably for patients' basic information,such as age(18?30,31?50,51?70,or 70),sex,body mass index,ASA level(?,?),smoking,drinking,married/single,education(primary and below,primary,junior,senior,undergraduate,postgraduate),physical exercise,anxiety values at 1 days before operation(20?30,30?40,>40)and so on.Consult carefully,measure truly and record in detail the predictors during and after the operation,such as the incision length,types of surgery(thoracoscopy,being converted to thoracotomy,or thoracotomy),the anesthesia information,the length of operation,the position of incision(left/right),the length of drainage,pain values during activity at 1,2,3,5,7 days after operation,pain values during activity at 2 months after operation,anxiety values at 1 days after operation(20?30,30?40,>40),anxiety values at 7 days after operation(20?30,30?40,>40).This study mainly used the state anxiety inventory(SAI)and the numerical rating scale(NRS)to measure data.Before,during and after operation,this study used several ways and means by visiting during the hospital period,spot observation,looking up the records,telephone,QQ,WeChat,reviewing in hospital or visiting to the patients' house in order to get maximizly the effective information of each patient.The incidence of CPSP was calculated according to the pain at 2 months after operation,and the patients were divided into the CPSP group and the non-CPSP group.First of all,the single factor analysis was used to summarize and determine the influencing factors of chronic post-surgical pain.Secondly,use the logarithmic regression analysis of binary variables to analyze the relationship between CPSP(the dependent variable)and influencing factors(the covariant quantity).Finally,risk factors of CPSP were identified.ResultsIn this study,a total of 349 patients were scheduled for follow-up visits.The success rate of follow-up visits was 92.3%.91 patients appeared pain during activity at 2 months after operation,and the incidence of postoperative chronic pain was 26.1%.The single factor analysis showed that there were statistically significant variables in CPSP and non-CPSP groups,which are the incision length,types of surgery,anxiety values at 1 days before operation(>40),anxiety values at 1 days after operation(>40),and pain values during activity at 1,2,3days after operation.The logarithmic regression analysis of binary variables showed that there were statistically significant variables(P<0.05)between the dependent variable(CPSP)and covariant quantities which are anxiety values at 1 days before operation(>40),anxiety values at 1 days after operation(>40),and pain values during activity at 1,2days after operation.ConclusionThe incidence of chronic pain after thoracic surgery was 26.1%.Anxiety values at 1 days before operation(>40),anxiety values at 1 days after operation(>40),and pain values during activity at 1,2days after operation are the risk factors for chronic pain after thoracic surgery in this studay.