Analysis on pain after discharged in patients with radical total gastrectomy under painless ward management_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Wenbin , YANG Xuewen , XU Guanghui , XIAO Shuao , CAI Lei , SUN Li ,  ZHANG Hongwei

Department of Digestive Surgrey, The First Affiliated Hospital of Air Force Military Medical University, Xi’an 710032, P. R. China;

Corresponding author：

ZHANG Hongwei, Email: zhanghw@fmmu.edu.cn

Keywords：

painless ward; pain; radical total gastrectomy; follow-up after discharge

DOI：

10.7507/1007-9424.201711031

Video：

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Objective To explore the pain after discharged in patients with radical total gastrectomy under painless ward management, and to analyze the causes of pain in order to guide the treatment strategy after discharge. Methods Retrospective analysis was performed on the pain data of 82 patients who underwent radical total gastrectomy in The First Affiliated Hospital of Air Force Military Medical University from December 2015 to April 2017, and the situation of pain was followed-up at 2 weeks, 1 month, 2 months, and 3 months after discharged. Results Mild pain occurred in 25 patients at the 2 weeks after discharged; mild pain occurred in 38 patients and moderate pain occurred in7 patients at the first month after discharged; mild pain occurred in 31 patients and moderate pain occurred in 4 patients at the second month after discharged; 19 patients had mild pain at the third month after discharged. There was no significant difference in pain scores between male patients and female patients, <60 years old patients and ≥60 years old patients, patients’ operative time<180 min and patients’ operative time ≥180 min, patients’ intraoperative blood loss<200 mL and patients’ intraoperative blood loss ≥200 mL at the all time points, including the second week, the first, the second, and the third month after discharge ( P>0.05). Conclusion Painless ward management can effectively control the degree of pain in discharged patients who underwent radical total gastrectomy.

Citation： WANG Wenbin, YANG Xuewen, XU Guanghui, XIAO Shuao, CAI Lei, SUN Li, ZHANG Hongwei. Analysis on pain after discharged in patients with radical total gastrectomy under painless ward management. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(6): 702-707. doi: 10.7507/1007-9424.201711031 Copy

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16.	乔晓斐, 荚卫东, 吕建国, 等. 肝切除患者出院后疼痛随访分析. 中国普外基础与临床杂志, 2015, 22(10): 1168-1170.
17.	徐建国. 成人术后疼痛治疗进展. 临床麻醉学杂志, 2011, 27(3): 299-301.
18.	彭慕云, 杨晓苏. 疼痛性别差异机制的研究进展. 中国疼痛医学杂志, 2013, 19(11): 690-692, 697.
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23.	陈国良, 王梅, 路桂军, 等. 慢性疼痛患者焦虑、抑郁状况调查及相关因素分析. 中国疼痛医学杂志, 2014, 20(4): 226-230, 235.
24.	谢晓燕, 张娟, 赵莉, 疼痛和抑郁共患机制的研究进展. 中国疼痛医学杂志, 2016, 22(01): 50-54.
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26.	Shipton EA. The transition from acute to chronic post surgical pain. Anaesth Intensive Care, 2011, 39(5): 824-836.

1. 中华医学会骨科学分会. 骨科常见疼痛的处理专家建议. 中华骨科杂志, 2008, 28(1): 78-81.
2. 中华医学会麻醉学分会. 成人术后疼痛处理专家共识. 临床麻醉学杂志, 2010, 26(3): 190-196.
3. 冷希圣, 韦军民, 刘连新, 等. 普通外科围手术期疼痛处理专家共识. 中华普通外科杂志, 2015, 30(2): 166-173.
4. 江志伟, 李宁, 黎介寿. 快速康复外科的概念及临床意义. 中国实用外科杂志, 2007, 27(2): 131-133.
5. Kehlet H. Fast-track colorectal surgery. Lancet, 2008, 371(9615): 791-793.
6. McLeod RS, Aarts MA, Chung F, et al. Development of an Enhanced Recovery After Surgery Guideline and Implementation Strategy Based on the Knowledge-to-action Cycle. Ann Surg, 2015, 262(6): 1016-1025.
7. Elvir-Lazo OL, White PF. Postoperative pain management after ambulatory surgery: role of multimodal analgesia. Anesthesiol Clin, 2010, 28(2): 217-224.
8. Wu CL, Raja SN. Treatment of acute postoperative pain. Lancet, 2011, 377(9784): 2215-2225.
9. American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology, 2012, 116(2): 248-273.
10. 荚卫东, 乔晓斐. 精准肝脏外科时代无痛病房建设. 中华消化外科杂志, 2014, 13(6): 415-418.
11. Brunelli C, Zecca E, Martini C, et al. Comparison of numerical and verbal rating scales to measure pain exacerbations in patients with chronic cancer pain. Health Qual Life Outcomes, 2010, 8: 42.
12. Wildgaard K, Ravn J, Kehlet H. Chronic post-thoracotomy pain: a critical review of pathogenic mechanisms and strategies for prevention. Eur J Cardiothorac Surg, 2009, 36(1): 170-180.
13. 许杨, 苏园林. 手术或创伤后的慢性疼痛. 中国疼痛医学杂志, 2011, 17(9): 536-537.
14. McGreevy K, Bottros MM, Raja SN. Preventing Chronic Pain following Acute Pain: Risk Factors, Preventive Strategies, and their Efficacy. Eur J Pain Suppl, 2011, 5(2): 365-372.
15. Baliki MN, Chialvo DR, Geha PY, et al. Chronic pain and the emotional brain: specific brain activity associated with spontaneous fluctuations of intensity of chronic back pain. J Neurosci, 2006, 26(47): 12165-12173.
16. 乔晓斐, 荚卫东, 吕建国, 等. 肝切除患者出院后疼痛随访分析. 中国普外基础与临床杂志, 2015, 22(10): 1168-1170.
17. 徐建国. 成人术后疼痛治疗进展. 临床麻醉学杂志, 2011, 27(3): 299-301.
18. 彭慕云, 杨晓苏. 疼痛性别差异机制的研究进展. 中国疼痛医学杂志, 2013, 19(11): 690-692, 697.
19. Lawson KP, Nag S, Thompson AD, et al. Sex-specificity and estrogen-dependence of kappa opioid receptor-mediated antinociception and antihyperalgesia. Pain, 2010, 151(3): 806-815.
20. Poleshuck EL, Katz J, Andrus CH, et al. Risk factors for chronic pain following breast cancer surgery: a prospective study. J Pain, 2006, 7(9): 626-634.
21. Brennan TJ. Pathophysiology of postoperative pain. Pain, 2011, 152(3 Suppl): S33-S40.
22. Kukushkin ML. Mechanism of development and principles of etiopathogenic therapy of chronic pain. Zh Nevrol Psikhiatr Im S S Korsakova, 2012, 112(2): 89-94.
23. 陈国良, 王梅, 路桂军, 等. 慢性疼痛患者焦虑、抑郁状况调查及相关因素分析. 中国疼痛医学杂志, 2014, 20(4): 226-230, 235.
24. 谢晓燕, 张娟, 赵莉, 疼痛和抑郁共患机制的研究进展. 中国疼痛医学杂志, 2016, 22(01): 50-54.
25. Rottmann N, Dalton SO, Bidstrup PE, et al. No improvement in distress and quality of life following psychosocial cancer rehabilitation. A randomised trial. Psychooncology, 2012, 21(5): 505-514.
26. Shipton EA. The transition from acute to chronic post surgical pain. Anaesth Intensive Care, 2011, 39(5): 824-836.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis on pain after discharged in patients with radical total gastrectomy under painless ward management

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