Characteristics of Postoperative Pain After VATS and Pain-Related Factors: The Experience in National Cancer Center of China

Yao Tong, Peipei Wei, Shuang Wang, Qiuying Sun, Yanzheng Cui, Ning Ning, Sitong Chen, Xin He, Yao Tong, Peipei Wei, Shuang Wang, Qiuying Sun, Yanzheng Cui, Ning Ning, Sitong Chen, Xin He

Abstract

Purpose: No final conclusion has yet been reached on characteristics of postoperative pain and pain-related factors after video-assisted thoracoscopic surgery (VATS). This study was designed to explore features of acute severe pain and chronic post-surgical pain (CPSP), and the pain-related factors of VATS.

Patients and methods: Data of patients who underwent VATS for lung cancer in Cancer Hospital, Chinese Academy of Medical Sciences between March 2017 and January 2019 were reviewed in this retrospective study. A numerical rating scale (NRS) was used for evaluating the intensity of postoperative pain including no pain (NRS=0), mild pain (NRS=1-3), moderate pain (NRS=4-6), and severe pain (NRS=7-10). Pain intensity was assessed daily within a week after operation, and also evaluated at 3 months postoperatively.

Results: One hundred and five (3.4%) of the 3072 patients enrolled experienced severe pain (NRS=7-10) on the 1st day after operation, and 17 (0.6%) on the 2nd day. Smoking history, three-port VATS, prolonged operation time, and without patient-controlled analgesia (PCA) were correlated to increased incidence of severe pain. Among all patients, 237 (7.7%) cases generated CPSP, and VATS type, operation time, duration of drainage, and severe pain on the 1st day were four independent risk factors related to CPSP.

Conclusion: Patients seemed to experience a lower incidence of acute severe pain and CPSP after VATS than traditional open surgery. Acute severe pain was correlated with smoking history, VATS type, operation time, and PCA; VATS type, operation time, duration of drainage, and severe pain on the 1st day postoperatively were four independent risk factors of CPSP.

Keywords: NRS; VATS; acute severe pain; chronic post-surgical pain; risk factor.

Conflict of interest statement

The authors report no conflicts of interest in this work.

© 2020 Tong et al.

Figures

Figure 1
Figure 1
The change of mean NRS (numerical rating scale) scores from the 1st to the 7th day postoperatively.
Figure 2
Figure 2
The different percentages for each pain intensity within the first week after operation.

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