| 摘要: |
| 目的 探讨腹腔镜胃肠肿瘤手术患者急性术后疼痛与疼痛敏感性的相关性。方法 选取择期行全身麻醉下腹腔镜胃肠肿瘤手术的患者50例，性别不限，年龄≥18岁，美国麻醉医师协会（ASA）分级Ⅰ～Ⅱ级。根据术前疼痛敏感性问卷（PSQ）评分结果分为疼痛高敏感性组（PSQ评分≥5.0分，n＝19）和低敏感性组（PSQ评分＜5.0分，n＝31）。记录两组患者的一般情况、手术情况，术后24 h内镇痛泵按压次数、补救镇痛次数，以及术后恶心、呕吐、嗜睡、腹胀等并发症的发生情况。采用视觉模拟量表（VAS）评分评估患者外周静脉置管及术后24 h内疼痛程度。结果 两组患者的年龄、性别、ASA分级、BMI、手术时间、全身麻醉苏醒时间、气管导管拔管时间、术后24 h镇痛泵按压次数、术后并发症发生率比较差异均无统计学意义（均P＞0.05）。与低敏感性组比较，高敏感性组外周静脉置管及术后清醒即刻、1 h、2 h的VAS评分较高（均P＜0.05）。术前PSQ评分与外周静脉置管VAS评分呈正相关（r＝0.693，P＜0.05），与术后清醒即刻、1 h、2 h的VAS评分呈正相关（r＝0.917、0.901、0.841，均P＜0.05）。高敏感性组术后2 h补救镇痛次数较低敏感性组多（P＜0.05）。以术前PSQ评分为检验变量、是否发生急性术后疼痛为状态变量绘制ROC曲线，其AUC为0.909，通过约登指数计算出PSQ评分最佳临界值为4.85分，提示采用PSQ评分可预测腹腔镜胃肠肿瘤手术患者急性术后疼痛的发生。结论 疼痛敏感性与腹腔镜胃肠肿瘤手术患者急性术后疼痛的发生有关，可能成为急性术后疼痛发生的预测指标，术前PSQ≥4.85分者发生急性术后疼痛的可能性更高。 |
| 关键词: 疼痛敏感性 疼痛敏感性问卷 胃肠肿瘤 急性术后疼痛 |
| DOI：10.16781/j.CN31-2187/R.20230617 |
| 投稿时间：2023-11-09修订日期：2024-03-15 |
| 基金项目: |
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| Correlation of pain sensitivity with acute postoperative pain in patients undergoing laparoscopic gastrointestinal tumor surgery |
| DING Lirong,HONG Xinhua,LI Zhuang,SU Zhen,LIU Hailin* |
(Department of Anesthesiology, The Huai'an First People's Hospital Affiliated to Nanjing Medical University, Huai'an 223300, Jiangsu, China
* Corresponding author) |
| Abstract: |
| Objective To investigate the correlation between pain sensitivity and acute postoperative pain in patients undergoing laparoscopic gastrointestinal tumor surgery. Methods Fifty patients of either sex, aged≥18 years, with American Society of Anesthesiologists (ASA) gradeⅠ-Ⅱ, who were scheduled for laparoscopic gastrointestinal tumor surgery under general anesthesia were divided into high sensitivity group (pain sensitivity questionnaire ［PSQ］ score≥5.0, n＝19) and low sensitivity group (PSQ score＜5.0, n＝31). The general conditions, operation conditions, the number of analgesic pump compressions and the number of salvage analgesia within 24 h after surgery, and the complications such as nausea, vomiting, drowsiness, and abdominal distension of the 2 groups were recorded. Visual analogue scale (VAS) score was used to evaluate the pain degree of patients during peripheral venous catheterization and within 24 h after surgery. Results There were no significant differences in age, gender, ASA grade, body mass index, operation duration, recovery time, extubation time, number of analgesic pump compressions within 24 h after surgery, or postoperative complications between the 2 groups (all P＞0.05). Compared with the low sensitivity group, the VAS scores of the high sensitivity group were significantly higher during peripheral venous catheterization, immediately after waking, 1 h and 2 h after surgery (all P＜0.05). The preoperative PSQ score was positively correlated with the VAS score of peripheral venous catheterization (r＝0.693, P＜0.05), and was positively correlated with the VAS scores immediately after waking, 1 h and 2 h after surgery (r＝0.917, 0.901 and 0.841, all P＜0.05). The number of salvage analgesia in the high sensitivity group was significantly higher than that in the low sensitivity group (P＜0.05). The preoperative PSQ score was used as the test variable, and the occurrence of acute postoperative pain was used as the state variable to plot the receiver operating characteristic curve. The area under curve value was 0.909. The optimal cut-off value of PSQ score calculated by Jorden index was 4.85, suggesting that the PSQ score could predict the acute postoperative pain in patients undergoing laparoscopic gastrointestinal tumor surgery. Conclusion Pain sensitivity is associated with acute postoperative pain in patients undergoing laparoscopic gastrointestinal tumor surgery, and it may be a predictor of acute postoperative pain. Patients with PSQ≥4.85 are more likely to develop acute postoperative pain. |
| Key words: pain sensitivity pain sensitivity questionnaire gastrointestinal neoplasms acute postoperative pain |
