Predictive Factors for Acute Postoperative Pain After Open Radical Gastrectomy for Gastric Cancer

Abstract

BackgroundPain has become an important factor in evaluating patients' quality of life and clinical treatment. For gastric cancer (GC) patients, open radical gastrectomy (OG) causes significant trauma to the body, increases patients' pain after operation, and delays early recovery. The aim of this study was to investigate the predictive factors of acute pain after OG within postoperative 72 h.MethodsFrom March 2020 to September 2021, 307 patients who underwent OG were included in the study in Nanjing Drum Tower Hospital. The predictors included demographic predictors, pathological data, surgical predictors, and intraoperative predictors. The pain scores at 12, 24, 48, and 72 h after operation were evaluated by numeric rating scale (NRS). The predictors of acute pain were determined by univariate and multivariate analysis.ResultsThe average pain score (NRS) of patients showed a downward trend over time within 72 h after OG. Multivariate analysis indicated that total gastrectomy (OR 1.823, 95% CI 1.094–3.040, P < 0.05), AJCC TNM stage (II) (OR.232, 95% CI 0.062–0.872, P < 0.05), AJCC TNM stage(III) (OR.185, 95% CI 0.049–0.698, P < 0.05), BMI (kg/m2) (OR 1.75, 95% CI 1.029–2.976, P < 0.05), distant metastasis (OR 3.054, 95% CI 1.019–9.155, P < 0.05), intraoperative transfusion (OR 2.246, 95% CI 1.267–3.982, P < 0.01) were significant predictive factors for acute pain after OG.ConclusionReasonable postoperative acute pain control was the prerequisite for accelerating the postoperative rehabilitation of patients. In order to reduce the occurrence of excessive or insufficient analgesia, it was necessary for patients who underwent OG to formulate appropriate analgesics according to risk factors.

Risk Factors for Acute Postsurgical Pain: A Narrative Review

“…Prospective and retrospective cohort studies have revealed that ALND is among the independent predictors of moderate-to-severe acute pain following breast cancer surgery. 22,38,72 Additionally, this surgical approach exhibited an independent association with APSP among other surgery types, such as inguinal hernia repair, 62 cesarean section, 69 open radical gastrectomy, 56 and endoscopic sinus surgery. 63 Postoperative pain is generally accepted to be more severe in patients undergoing major surgeries or surgeries with more extensive nerve damage.…”

“…55 Two prospective cohort studies and one cross-sectional study have shown that BMI can independently predict acute pain intensity or severity after knee arthroplasty. 30,45,49 Moreover, BMI was reported to be a significant risk factor for moderate-to-severe acute pain after open radical gastrectomy, 56 thoracoscopic surgery, 29 and breast cancer surgery. 38 One retrospective study and one cross-section study have noted the correlation between BMI and APSP.…”

Changes in spinal alignment one month post abdominal surgery: A prospective cohort study

“…[1] The number of abdominal surgeries is increasing, especially in East Asian countries such as Japan due to the large number of cancer patients. [2] The most common complication following abdominal procedures is pain centered around the surgical wound, and many reports regarding its intensity, changes, associations with cancer site, [3,4] surgical technique, [5] and long-term duration have been published. [6] Various treatment strategies for postoperative pain have been investigated including reducing the release of inflammatory cytokines through preoperative nutritional therapy, [7] intraoperative anesthetic administration, [8] and application of postoperative analgesics, [9,10] among others.…”