Situation of postoperative acute pain management in colorectal cancer patient in enhanced recovery after surgery mode and its influencing factors_West China Medical Journal

Authors：

HUANG Mingjun ¹ , WANG Xiaodong ² ,  LI Ka ³

1. Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of GI Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. West China Nursing School, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LI Ka, Email: lika127@126.com

Keywords：

Enhanced recovery after surgery; Colorectal cancer; Postoperative pain; Pain management

DOI：

10.7507/1002-0179.201811063

Video：

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Objective To describe the situation of postoperative pain management in colorectal cancer patient in enhanced recovery after surgery (ERAS) mode, and explore its influenceing factors. Methods From March to December 2017, colorectal cancer patients in ERAS mode in Department of Gastrointestinal Surgery, West China Hospital of Sichuan University were selected. On the third day after surgery, a total of 74 patients with acute pain completed a questionnaire, which was composed of a demographic form, the Houston Pain Outcome Instrument (HPOI), Self-Rating Anxiety Scale, and Social Support Rating Scale. Mean±standard deviation and percentage were used to describe the total score of pain experience, t test, analysis of variance, Spearman correlation analysis were used for single-factor analysis, and multiple linear regression was used for multi-factor analysis. Results The mean total score of pain experience was 15.1±3.8. Single-factor analysis results showed that the affection of pain on daily life (r_s=0.270, P=0.020), satisfaction of pain controlling education (r_s=–0.283, P=0.015), subjective support (r_s=–0.326, P=0.005), and social support utilization (r_s=–0.253, P=0.029) were correlated with the total score of pain experience. Multi-factor analysis results showed that satisfaction of pain controlling education (P<0.001) and subjective support (P=0.005) were negative influencing factors of postoperative pain experience score, and severe anxiety (P=0.001) and pain expectation after surgery (P=0.016) were positive influencing factors of postoperative pain experience score. Conclusions Pain management situation is not so bad in these patients. High satisfaction of pain controlling education and high subjective social support are helpful to decrease pain. The medical staff should pay more attention to patients with severe anxiety, and help patients to establish reasonable pain expectation after surgery.

Citation： HUANG Mingjun, WANG Xiaodong, LI Ka. Situation of postoperative acute pain management in colorectal cancer patient in enhanced recovery after surgery mode and its influencing factors. West China Medical Journal, 2018, 33(12): 1486-1490. doi: 10.7507/1002-0179.201811063 Copy

1.	郑艳, 付沫, 李玉萧, 等. MEWS 结合 VAS 评分提高急性疼痛留观病人危重症早期识别率的效果观察. 护理研究, 2017, 31(21): 2597-2600.
2.	李晓松. 医学统计学. 3 版. 北京: 高等教育出版社, 2014: 254-257.
3.	李立, 汪晓东, 舒晔, 等. 四川大学华西医院肛肠外科·结直肠外科快速流程临床指南 (二). 中国普外基础与临床杂志, 2009, 16(6): 493-494.
4.	李立, 汪晓东, 舒晔, 等. 四川大学华西医院肛肠外科·结直肠外科快速流程临床指南 (三). 中国普外基础与临床杂志, 2009, 16(7): 581.
5.	李立, 汪晓东, 舒晔, 等. 四川大学华西医院肛肠外科·结直肠外科快速流程临床指南 (四). 中国普外基础与临床杂志, 2009, 16(8): 671-671.
6.	李立, 汪晓东, 舒晔, 等. 四川大学华西医院肛肠外科·结直肠外科快速流程临床指南 (一). 中国普外基础与临床杂志, 2009, 16(5): 413.
7.	王远鹏, 刘会春, 黄伟, 等. 加速康复外科理念在肝癌切除围手术期的应用研究. 中华普通外科杂志, 2017, 32(3): 243-246.
8.	McNeill J, Sherwood G, Starck P, et al. Design strategies in pain management research with Hispanics. Hisp Health Care Int, 2003, 2(2): 73-80.
9.	沈曲, 李峥. 休斯顿疼痛情况调查表信度和效度的研究. 中华护理杂志, 2006, 41(11): 1049-1051.
10.	肖水源. 社会支持评定量表//汪向东, 王希林, 马弘. 心理卫生评定量表手册增订版. 北京: 中国心理卫生杂志出版社, 1999: 127.
11.	戴晓阳. 常用心理评估量表手册. 北京: 人民军医出版社, 2010: 153-155.
12.	朱丽, 赵梅珍. 快速康复外科多模式镇痛在肠道手术病人中的应用. 全科护理, 2015, 2(6): 481-483.
13.	陈晓琳, 丁娟, 朱赟. 前列腺癌患者术前焦虑与术后疼痛的相关性分析. 中国临床医学, 2012, 19(3): 278-279.
14.	杨利芬. 中医综合护理方案干预腹部手术患者术前焦虑抑郁的临床研究. 辽宁中医杂志, 2015, 42(3): 625-627.
15.	Loggia ML, Jensen K, Gollub RL, et al. The catechol-O-methyl transferase (COMT) val158met polymorphism affects brain responses to repeated painful stimuli. PLoS One, 2011, 6(11): c27764.
16.	Kim S, Lee YJ, Lee S, et al. Assessment of pain and anxiety following surgical placement of dental implants. Int J Oral Maxillofac Implants, 2013, 28(2): 531-535.
17.	McNeill JA, Sherwood GD, Starck PL, et al. Pain management outcomes for hospitalized Hispanic patients. Pain Manag Nurs, 2001, 2(1): 25-36.
18.	Ward SE, Gordon D. Application of the American pain society quality assurance standards. Pain, 1994, 56(3): 299-306.
19.	张殿群, 王俊刚, 耿艳萌, 等. 临床慢性疼痛患者的社会支持与及性格特征调查. 中国医学伦理学, 2009, 6(3): 82-83.
20.	Thomas T, Robinson C, Champion D, et al. Pain management outcomes for hospitalized Hispanic patients. Pain Manag Nurs, 2001, 2(1): 25-36.
21.	戚芳, 丁焱. 产妇分娩疼痛体验及对疼痛管理期望的质性研究. 上海护理, 2018, 18(10): 28-33.

1. 郑艳, 付沫, 李玉萧, 等. MEWS 结合 VAS 评分提高急性疼痛留观病人危重症早期识别率的效果观察. 护理研究, 2017, 31(21): 2597-2600.
2. 李晓松. 医学统计学. 3 版. 北京: 高等教育出版社, 2014: 254-257.
3. 李立, 汪晓东, 舒晔, 等. 四川大学华西医院肛肠外科·结直肠外科快速流程临床指南 (二). 中国普外基础与临床杂志, 2009, 16(6): 493-494.
4. 李立, 汪晓东, 舒晔, 等. 四川大学华西医院肛肠外科·结直肠外科快速流程临床指南 (三). 中国普外基础与临床杂志, 2009, 16(7): 581.
5. 李立, 汪晓东, 舒晔, 等. 四川大学华西医院肛肠外科·结直肠外科快速流程临床指南 (四). 中国普外基础与临床杂志, 2009, 16(8): 671-671.
6. 李立, 汪晓东, 舒晔, 等. 四川大学华西医院肛肠外科·结直肠外科快速流程临床指南 (一). 中国普外基础与临床杂志, 2009, 16(5): 413.
7. 王远鹏, 刘会春, 黄伟, 等. 加速康复外科理念在肝癌切除围手术期的应用研究. 中华普通外科杂志, 2017, 32(3): 243-246.
8. McNeill J, Sherwood G, Starck P, et al. Design strategies in pain management research with Hispanics. Hisp Health Care Int, 2003, 2(2): 73-80.
9. 沈曲, 李峥. 休斯顿疼痛情况调查表信度和效度的研究. 中华护理杂志, 2006, 41(11): 1049-1051.
10. 肖水源. 社会支持评定量表//汪向东, 王希林, 马弘. 心理卫生评定量表手册增订版. 北京: 中国心理卫生杂志出版社, 1999: 127.
11. 戴晓阳. 常用心理评估量表手册. 北京: 人民军医出版社, 2010: 153-155.
12. 朱丽, 赵梅珍. 快速康复外科多模式镇痛在肠道手术病人中的应用. 全科护理, 2015, 2(6): 481-483.
13. 陈晓琳, 丁娟, 朱赟. 前列腺癌患者术前焦虑与术后疼痛的相关性分析. 中国临床医学, 2012, 19(3): 278-279.
14. 杨利芬. 中医综合护理方案干预腹部手术患者术前焦虑抑郁的临床研究. 辽宁中医杂志, 2015, 42(3): 625-627.
15. Loggia ML, Jensen K, Gollub RL, et al. The catechol-O-methyl transferase (COMT) val158met polymorphism affects brain responses to repeated painful stimuli. PLoS One, 2011, 6(11): c27764.
16. Kim S, Lee YJ, Lee S, et al. Assessment of pain and anxiety following surgical placement of dental implants. Int J Oral Maxillofac Implants, 2013, 28(2): 531-535.
17. McNeill JA, Sherwood GD, Starck PL, et al. Pain management outcomes for hospitalized Hispanic patients. Pain Manag Nurs, 2001, 2(1): 25-36.
18. Ward SE, Gordon D. Application of the American pain society quality assurance standards. Pain, 1994, 56(3): 299-306.
19. 张殿群, 王俊刚, 耿艳萌, 等. 临床慢性疼痛患者的社会支持与及性格特征调查. 中国医学伦理学, 2009, 6(3): 82-83.
20. Thomas T, Robinson C, Champion D, et al. Pain management outcomes for hospitalized Hispanic patients. Pain Manag Nurs, 2001, 2(1): 25-36.
21. 戚芳, 丁焱. 产妇分娩疼痛体验及对疼痛管理期望的质性研究. 上海护理, 2018, 18(10): 28-33.

West China Medical Journal

Situation of postoperative acute pain management in colorectal cancer patient in enhanced recovery after surgery mode and its influencing factors

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