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.	鄭艷, 付沫, 李玉蕭, 等. MEWS 結合 VAS 評分提高急性疼痛留觀病人危重癥早期識別率的效果觀察. 護理研究, 2017, 31(21): 2597-2600.
2.	李曉松. 醫學統計學. 3 版. 北京: 高等教育出版社, 2014: 254-257.
3.	李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南 (二). 中國普外基礎與臨床雜志, 2009, 16(6): 493-494.
4.	李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南 (三). 中國普外基礎與臨床雜志, 2009, 16(7): 581.
5.	李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南 (四). 中國普外基礎與臨床雜志, 2009, 16(8): 671-671.
6.	李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南 (一). 中國普外基礎與臨床雜志, 2009, 16(5): 413.
7.	王遠鵬, 劉會春, 黃偉, 等. 加速康復外科理念在肝癌切除圍手術期的應用研究. 中華普通外科雜志, 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, 李崢. 休斯頓疼痛情況調查表信度和效度的研究. 中華護理雜志, 2006, 41(11): 1049-1051.
10.	肖水源. 社會支持評定量表//汪向東, 王希林, 馬弘. 心理衛生評定量表手冊增訂版. 北京: 中國心理衛生雜志出版社, 1999: 127.
11.	戴曉陽. 常用心理評估量表手冊. 北京: 人民軍醫出版社, 2010: 153-155.
12.	朱麗, 趙梅珍. 快速康復外科多模式鎮痛在腸道手術病人中的應用. 全科護理, 2015, 2(6): 481-483.
13.	陳曉琳, 丁娟, 朱赟. 前列腺癌患者術前焦慮與術后疼痛的相關性分析. 中國臨床醫學, 2012, 19(3): 278-279.
14.	楊利芬. 中醫綜合護理方案干預腹部手術患者術前焦慮抑郁的臨床研究. 遼寧中醫雜志, 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.	張殿群, 王俊剛, 耿艷萌, 等. 臨床慢性疼痛患者的社會支持與及性格特征調查. 中國醫學倫理學, 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. 產婦分娩疼痛體驗及對疼痛管理期望的質性研究. 上海護理, 2018, 18(10): 28-33.

1. 鄭艷, 付沫, 李玉蕭, 等. MEWS 結合 VAS 評分提高急性疼痛留觀病人危重癥早期識別率的效果觀察. 護理研究, 2017, 31(21): 2597-2600.
2. 李曉松. 醫學統計學. 3 版. 北京: 高等教育出版社, 2014: 254-257.
3. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南 (二). 中國普外基礎與臨床雜志, 2009, 16(6): 493-494.
4. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南 (三). 中國普外基礎與臨床雜志, 2009, 16(7): 581.
5. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南 (四). 中國普外基礎與臨床雜志, 2009, 16(8): 671-671.
6. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南 (一). 中國普外基礎與臨床雜志, 2009, 16(5): 413.
7. 王遠鵬, 劉會春, 黃偉, 等. 加速康復外科理念在肝癌切除圍手術期的應用研究. 中華普通外科雜志, 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, 李崢. 休斯頓疼痛情況調查表信度和效度的研究. 中華護理雜志, 2006, 41(11): 1049-1051.
10. 肖水源. 社會支持評定量表//汪向東, 王希林, 馬弘. 心理衛生評定量表手冊增訂版. 北京: 中國心理衛生雜志出版社, 1999: 127.
11. 戴曉陽. 常用心理評估量表手冊. 北京: 人民軍醫出版社, 2010: 153-155.
12. 朱麗, 趙梅珍. 快速康復外科多模式鎮痛在腸道手術病人中的應用. 全科護理, 2015, 2(6): 481-483.
13. 陳曉琳, 丁娟, 朱赟. 前列腺癌患者術前焦慮與術后疼痛的相關性分析. 中國臨床醫學, 2012, 19(3): 278-279.
14. 楊利芬. 中醫綜合護理方案干預腹部手術患者術前焦慮抑郁的臨床研究. 遼寧中醫雜志, 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. 張殿群, 王俊剛, 耿艷萌, 等. 臨床慢性疼痛患者的社會支持與及性格特征調查. 中國醫學倫理學, 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. 產婦分娩疼痛體驗及對疼痛管理期望的質性研究. 上海護理, 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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