수술 후 첫 48시간 동안의 수술후 통증에 영향을 미치는 요인

Abstract

Purpose: This prospective study was designed to investigate the incidence of acute postoperative pain (APP) ≥4 and the risk factors of APP≥ for the first 48 hours after surgery. Methods: Data from 531 surgical patients were collected from November, 2009 to May, 2010. APP was assessed from the time of arrival at the Post Anesthetic Care Unit (PACU) to the end of the post-operative 48 hours. Risk factors of APP≥ were analyzed by logistic regression analysis. Results: The incidence of APP ≥4 was 58.8% for the first postoperative 4 hours; 33.5%, 24 hours; 11.1%, 48 hours. The score of pain was 5.55, the highest on arriving at PACU; 5.03 at postoperative 30 minutes; 4.03 at 1 hour; 3.96 at 4 hours; 2.76 at 24 hours; 1.44 at 48 hours Risk factors for APP ≥4 were females (Odds ratio [OR], 1.94; p=.013), general anesthesia (OR, 4.29; p<.001) and patient controlled analgesia (PCA) (OR, 2.83; p<.001) at 4 hours after operation; body mass index (BMI) ≥25 (OR, 1.80; p=.009), duration of surgery ≥1 hour (OR, 2.87; p=.037), general anesthesia (OR, 3.99; p<.001) and PCA (OR, 6.23; p<.001) at 24 hours; general anesthesia (OR, 3.53; p=.003) and PCA (OR, 3.01; p=.013) at 48 hours. Conclusion: Surgical patients with BMI ≥25, PCA and general anesthesia seem to have a higher incidence of pain ≥4 through the first postoperative 48 hours.