Predictors and Influence of Postoperative Moderate-to-severe Pain of PACU in the Patients with Malignancy

Abstract

Background This study was identied the risk factors for and designed to investigate influence of postoperative moderate-to-severe pain of post anaesthesia care unit (PACU) in patients with malignancy. Methods A retrospective study was performed on 22600 cancer patients with malignancy who underwent elective radical surgery in the Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, between October 2020 and December 2021. All patients were transferred to the PACU after tracheal extubation. Patients were divided into two groups according to a visual analogue scale (VAS) score of > 3: the no-moderate-severe-pain group and moderate-to-severe-pain group. Data pertaining to demographic, surgical, anaesthetic, and other factors were recorded. Logistic regression analysis was performed to explore the risk factors associated with postoperative moderate-to-severe pain of PACU in patients with malignancy. Results The incidence of postoperative moderate-to-severe pain of PACU in patients with malignancy was 1.42%. Multivariate logistic regression analysis showed that male sex, chest surgery, abdominal surgery, intraoperative haemorrhage, intraoperative use of non-steroidal anti-inflammatory drugs (NSAIDs), duration of anaesthesia, postoperative vomiting, and hypothermia were risk factors for postoperative moderate-to-severe pain of PACU in patients with malignancy. Female sex and intraoperative NSAID use were protective factors. The area under the curve was 0.85. Moderate-to-severe pain in the PACU correlated with hypertension, hyperglycaemia, dysphoria, and hypoxemia (P < 0.05). Conclusions Clinicians should actively provide preoperative pain education for men, patients undergoing chest or abdominal surgery, and patients who may experience massive haemorrhage during surgery. Active temperature monitoring and heat preservation, assisted analgesia with NSAIDS, and anti-nausea drugs were performed during surgery. Pain assessment and management should be conducted in time to reduce the occurrence of postoperative moderate-to-severe pain of PACU in patients with malignancy. Trial registration The study was approved by the Clinical Research Ethics Committee of the First Affiliated Hospital of Wenzhou Medical University (No.KY2021-097) and registered in the Chictr.org.cn registration system on 06/12/2021(ChiCTR2100054013).