Relationship between pain outcomes and smoking history following video-assisted thoracic surgery for lobectomy: a retrospective study

Oh, Tak Kyu; Kim, Kwhanmien; Jheon, Sanghoon; Hwan, Sang; Hwang, Jung Won; Kim, Jin Hee; Jeon, Young Tae; Song, In Ae

doi:10.2147/jpr.s157957

Cited by 9 publications

(10 citation statements)

References 26 publications

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“…Based on previous studies, 1 , 37 smoking is considered to be associated with postoperative HA, which is also confirmed in our study. Both the univariate (OR: 2.61; 95%CI: 1.21–5.64, P =0.013) and multivariate analyses (AOR: 2.32; 95%CI: 0.94–5.72, P =0.069) in our study show that smoking is a risk factor for postoperative HA.…”

Section: Discussionsupporting

confidence: 91%

<p>Risk of Postoperative Hyperalgesia in Adult Patients with Preoperative Poor Sleep Quality Undergoing Open-heart Valve Surgery</p>

Zhang¹,

Wang²,

Wang³

et al. 2020

JPR

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Purpose: Studies have reported that preoperative poor sleep quality could decrease the pain threshold in patients undergoing noncardiac surgery. However, the risk of postoperative hyperalgesia (HA) in cardiac surgery patients with preoperative poor sleep quality remains unclear. Patients and Methods: We retrospectively collected clinical data from patients undergoing open-heart valve surgery between May 1 and October 31, 2019, in Fuwai Hospital (Beijing). We assessed preoperative sleep quality and postoperative pain severity using the Pittsburgh sleep quality index (PSQI) and numerical pain rating scale (NPRS), respectively. A PSQI of six or greater was considered to indicate poor sleep quality, and a NPRS of four or greater was considered to indicate HA. Multivariable logistic regression analysis was used to study the risk of postoperative HA in patients with preoperative poor sleep quality. Results: We divided 214 eligible patients into two groups based on postoperative HA; HA group: n=61 (28.5%) and nonHA group: n=153 (71.5%). Compared with nonHA patients, patients with postoperative HA showed a higher percentage of history of smoking, 17 (11.1%) vs 15 (24.6%) and alcohol abuse, 5 (3.3%) vs 6 (9.8%), higher intraoperative dose of sufentanil (median, 1.02 vs 1.12 μg/kg/h), and longer duration of ventilation with tracheal catheter (median, 760 vs 934 min). Preoperative poor sleep quality was associated independently with an increased risk of postoperative HA (adjusted odds ratio [AOR]: 2.66; 95%CI: 1.31-5.39, P=0.007). Stratification by history of smoking revealed a stronger risk of postoperative HA in nonsmoking patients with preoperative poor sleep quality (AOR: 3.40; 95%CI: 1.51-7.66, P=0.003). No risk was found in patients who had history of smoking (AOR: 0.83; 95%CI: 0.14-4.75, P=0.832). Conclusion: Preoperative poor sleep quality is an independent risk factor for postoperative HA in adult patients undergoing open-heart valve surgery who had no history of smoking.

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Section: Discussionsupporting

confidence: 91%

<p>Risk of Postoperative Hyperalgesia in Adult Patients with Preoperative Poor Sleep Quality Undergoing Open-heart Valve Surgery</p>

Zhang¹,

Wang²,

Wang³

et al. 2020

JPR

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“…More smokers underwent VATS compared with non-smokers, and it is therefore important to detect whether the increased risk for postoperative pain was smoking-related actually or if there was other explanations. And in VATS, the association between smoking history and postoperative pain was controversial 25,26 . The multiple analysis of this study indicated that presence of previous history of smoking increased the risk of moderate-severe acute pain following VATS by 86% (OR, 1.86; 95% CI, 1.29 to 2.70, P = 0.001).…”

Section: Discussionmentioning

confidence: 99%

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

Sun

Liu

Chen

et al. 2020

Sci Rep

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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. Moderate-severe pain after surgical procedures is associated with prolonged hospital stays, readmissions, patient dissatisfaction, development of chronic pain, decreased quality of life and increased costs 1,2. It is widely accepted that better management of postoperative pain results in better patients' recovery. Video assisted thoracoscopic surgery (VATS), compared to conventional thoracotomy, is notable for less tissue trauma, improved postoperative respiratory function, and increased tolerability for the patients 3. Although potentially less postoperative pain was generally expected as one of the benefits of VATS 4 , many patients still suffer moderate to severe pain postoperatively 2,5-7. There are several reasons contributing to this unsatisfactory situation, one of them being that some patients may have certain risk factors for occurrence of more severe postoperative pain 8. Early identification of patients at risk may help to allow early application of effective treatment strategies to prevent unexpected suffering in these patients. Previously, several studies have focused on the predictors of postoperative pain and demographic, social psychological and clinical factors have been identified contributing to the development of severe postoperative pain 5,6,8,9. However, most of them are cohorts with mixed surgical procedures while VATS is not included. Moreover, various subtypes of VATS (uniportal, multiportal and robotic) exist currently, and the lack of guideline results in variation of analgesia regimens and effectiveness of analgesia in different medical centers 10. To date, the predictive factors of moderate-severe postoperative pain following VATS were not reported, which is important for individual-specific pa...

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“…One cross-sectional study and one small-scale cohort study indicated that smoking cessation after cancer diagnosis reduced pain [ 97 ]. Regarding the relationship between cancer pain and pre- and postoperative smoking, nonsmokers had less opioid consumption in the immediate postoperative period [ 78 , 98 ], while smokers experienced greater chest and wound pain as well as a persistent decrease in physical and social functioning postoperatively [ 99 ]. Since nonsmokers had a higher postoperative quality of life (QOL) [ 99 ], patients undergoing surgery should be smoke-free to minimize the postoperative risks of pain chronification and functional impairments.…”

Section: Clinical Questionsmentioning

confidence: 99%

Consensus statement on smoking cessation in patients with pain

et al. 2022

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Smoking is closely associated with the development of various cancers and tobacco-related illnesses such as cardiovascular and respiratory disorders. However, data are scarce on the relationship between smoking and both acute and chronic pain. In addition to nicotine, tobacco smoke contains more than 4000 different compounds. Although nicotine is not the sole cause of smoking-induced diseases, it plays a critical role in pain-related pathophysiology. Despite the acute analgesic effects of nicotine, long-term exposure leads to tolerance and increased pain sensitivity due to nicotinic acetylcholine receptor desensitization and neuronal plastic changes. The purpose of smoking cessation interventions in smoking patients with pain is primarily not only to reduce their pain and associated limitations in activities of daily living, but also to improve the outcomes of underlying pain-causing conditions and reduce the risks of tobacco-related disorders. This statement aims to summarize the available evidence on the impact of smoking on pain and to inform medical professionals of the significance of smoking cessation in patients with pain.

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Relationship between pain outcomes and smoking history following video-assisted thoracic surgery for lobectomy: a retrospective study

Cited by 9 publications

References 26 publications

<p>Risk of Postoperative Hyperalgesia in Adult Patients with Preoperative Poor Sleep Quality Undergoing Open-heart Valve Surgery</p>

<p>Risk of Postoperative Hyperalgesia in Adult Patients with Preoperative Poor Sleep Quality Undergoing Open-heart Valve Surgery</p>

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

Consensus statement on smoking cessation in patients with pain

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