Moderate-severe postoperative pain in patients undergoing video-assisted thoracoscopic surgery: A retrospective study

Abstract

Moderate-severe pain after surgical procedures is associated with decreased quality of life and increased costs. This study aimed to identify the incidence and predictive factors of moderate-severe postoperative pain within 48 hours following video-assisted thoracoscopic surgery (VATS) in a tertiary hospital. A retrospective cohort analysis was performed using medical records of adult patients who underwent VATS between January 2015 and December 2016. Logistic regression was performed to identify predictive factors for moderate-severe pain (visual analogue scale, VAS ≥ 4) within 24 hours and within 48 hours postoperatively. Of the 1164 participants, the incidence of moderate-severe pain was 12.7% within the first 24 hours and 15.6% within the first 48 hours after surgery. In multivariable analysis, the independent risk factors related to moderate-severe pain within 24 hours after surgery were younger age, increased body mass index, preoperative pain within 1 month and history of smoking. The risk factors for moderate-severe acute pain within 48 hours were almost the same, except that the number of chest tubes were also included. Moderate-severe postoperative pain following VATS is not rare, and presence of several risk factors deserves more aggressive pain management strategies perioperatively.

Figure 1

The incidence of moderate-severe acute pain after VATS in four different age groups (quartiles, A) and different body mass index (BMI) groups (quartiles, B). Age of the four quartile groups were ≤52, 53–60, 61–67 and ≥68 and pain significantly increased at age ≤52 years. BMI of the four quartile groups were ≤20.6, 20.7–22.5, 22.6–24.8 and ≥24.9 and pain significantly increased as BMI grew.