Factors associated with moderate to severe pain after laparoscopic surgery

Abstract

Objective: The aim of this study was to describe associated factors of patients with moderate to severe pain after laparoscopic abdominal surgery in Post Anesthetic Care Unit. Material and Methods: This retrospective study included patients who underwent laparoscopic abdominal surgeries (bariatric, colorectal, gynecological, urological, and upper gastrointestinal surgery) between February and July 2019. Demo-graphic data were retrieved from the anesthetic records. Pain score was evaluated by self-rating using verbal numerical rating scale (0-10). Logistic regression was used to obtain independent risk factors of moderate to severe (score 4-10) pain against no or mild pain. Results: Two-hundred and ten patients were included. The incidence of moderate (score 4-6) to severe pain (score 7-10) was 50.0%. Those who suffered from moderate to severe pain required higher consumption of analgesic drugs in recovery room than the other groups, however durations of hospitalization were not different between the two groups (p-value=0.329). This was because the highest intensity of pain was in the first postoperative day. A multivariate logistic regression analysis revealed that abdominal pressure more than 12 mmHg (odd ratio (OR)=1.84, 95% confidence interval (CI) 0.8-4.22, p-value=0.153), and operation time more than 3 hours (OR 1.49, 95% CI 0.86-2.61, p-value=0.158) were independent risk factors of moderate to severe pain after laparoscopic procedure Conclusion: High intra-abdominal pressure (≥12 mmHg) and prolonged operation time (>3 hours) are the independent risk factors of moderate and severe pain in laparoscopic surgery.