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Journal of Cardiothoracic Surgery

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Open Access 01-12-2023 | Sufentanil | Research

Trajectory of pain threshold and its association with acute pain after thoracic surgery: a prospective observational study

Authors: Fei Wang, Meng-Chan Ou, Yi-Hao Zhu, Tao Zhu, Xue-Chao Hao

Published in: Journal of Cardiothoracic Surgery | Issue 1/2023

Abstract

Background

Postoperative analgesic management is an ongoing challenge. The pain threshold (PT) is an objective index that reflects the body’s sensitivity to pain and can be used for quantitative pain assessment. We hypothesized that the PT is correlated with postoperative pain and can thus be used to guide postoperative pain management.

Methods

This study involved 93 patients who underwent thoracoscopic surgery from December 2019 to February 2020. The PT was measured with transcutaneous electrical stimulation before surgery (T₀) and at 1 h (T₁), 6 h (T₆), and 24 h (T₂₄) after surgery. The visual analogue scale (VAS) score was used to evaluate the severity of postoperative pain at the same time. The PT variation (PTV) after surgery was calculated as the ratio of the postoperative PT to preoperative PT.

Results

The postoperative PT was higher than the preoperative PT and showed a downward trend within 24 h after surgery; the PTV also showed a downward trend within 24 h after surgery. PT-T₁ was negatively correlated with VAS-T₁ at rest and during motion (rest: VAS-T₁r = − 0.274, P = 0.008; motion: VAS-T₁r = − 0.298, P = 0.004). PTV-T₁ was negatively correlated with VAS-T₁ during motion (r = − 0.213, P = 0.04). Lower VAS-T₁ scores (< 4) at rest and during motion were associated with higher PT-T₁ (rest: t = 2.452, P = 0.016; motion: t = 2.138, P = 0.035). The intraoperative sufentanil dose was associated with a postoperative increase in PTV-T₁. Increased rescue analgesic administration was associated with PTV elevation. However, the incidence of dizziness in patients with moderate PTV-T₂₄ was lower than that in patients with high or low PTV-T₂₄ (χ² = 8.297, P = 0.015).

Conclusions

The postoperative PT was higher than the preoperative PT and showed a downward trend within 24 h after surgery; PTV also showed a downward trend within 24 h after surgery. The PT and PTV were negatively correlated with the pain intensity at rest and during motion and were associated with perioperative analgesic consumption and the incidence of adverse events.

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Title: Trajectory of pain threshold and its association with acute pain after thoracic surgery: a prospective observational study
Authors: Fei Wang
Meng-Chan Ou
Yi-Hao Zhu
Tao Zhu
Xue-Chao Hao
Publication date: 01-12-2023
Publisher: BioMed Central
Keyword: Sufentanil
Published in: Journal of Cardiothoracic Surgery / Issue 1/2023
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-023-02424-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Trajectory of pain threshold and its association with acute pain after thoracic surgery: a prospective observational study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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