Intravenous patient-controlled analgesia plus psychoeducational intervention for acute postoperative pain in patients with pulmonary nodules after thoracoscopic surgery: a retrospective cohort study

BMC Anesthesiology

Xian Ding¹  Sha Li¹  Xiao Chen¹  Jianfeng Huang²  Yong Zhao³ 

[1] Department of Anesthesiology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214125, Wuxi, Jiangsu, People’s Republic of China;Department of Radiation Oncology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214125, Wuxi, Jiangsu, People’s Republic of China;Department of Thoracic and Cardiovascular Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China;

关键词: Pulmonary nodule;    Thoracoscopic surgery;    Acute postoperative pain;    Intravenous patient-controlled analgesia;    Psychoeducational intervention;   

DOI  :  10.1186/s12871-021-01505-4

来源: Springer

【 摘 要 】

BackgroundThe association of psychological factors with postoperative pain has been well documented. The incorporation of psychoeducational intervention into a standard analgesia protocol seems to be an attractive approach for the management of acute postoperative pain. Our study aimed to evaluate the impact of psychoeducational intervention on acute postoperative pain in pulmonary nodule (PN) patients treated with thoracoscopic surgery.MethodsIn this study, 76 PN patients treated with thoracoscopic surgery and intravenous patient-controlled analgesia (IV-PCA) plus psychoeducational evaluation and intervention were selected as the psychoeducational intervention group (PG). Another 76 PN patients receiving IV-PCA without psychoeducational intervention after thoracoscopic surgery, treated as the control group (CG), were identified from the hospital database and matched pairwise with PG patients according to age, sex, preoperative body mass index (BMI), opioid medications used for IV-PCA and the educational attainment of patients.ResultsThe most common psychological disorders were anxiety and interpersonal sensitivity, which were recorded from 82.9% (63/76) and 63.2% (48/76) of PG patients. The numerical rating scale (NRS) pain scores of the PG patients were significantly lower than those of the CG patients at 2 and 24 h after surgery (P < 0.001). Total opioid consumption for acute postoperative pain in the PG was 52.1 mg of morphine equivalent, which was significantly lower than that (67.8 mg) in the CG (P = 0.038). PG patients had a significantly lower incidence of rescue analgesia than CG patients (28.9% vs. 44.7%, P = 0.044). Nausea/vomiting was the most common side effect of opioid medications, recorded for 3 (3.9%) PG patients and 10 (13.2%) CG patients (P = 0.042). In addition, no significant difference was observed between PG and CG patients in terms of grade 2 or higher postoperative complications (10.5% vs. 17.1%, P = 0.240).ConclusionsPsychoeducational intervention for PN patients treated with thoracoscopic surgery resulted in reduced acute postoperative pain, less opioid consumption and fewer opioid-related side effects.

【 授权许可】

CC BY