Postoperative pain after colorectal surgery. 2020

Margaretha Lindberg, and Oskar Franklin, and Johan Svensson, and Karl A Franklin
Department of Surgical and Perioperative Sciences, Surgery, Umeå University, SE-901 85, Umeå, Sweden.

OBJECTIVE Postoperative pain is a keystone in perioperative programs, as pain negatively impacts recovery. This study aimed to evaluate pain after elective colorectal surgery and to identify risk factors for postoperative pain. METHODS This prospective cohort study comprised consecutive patients undergoing elective colorectal surgery within the Enhanced Recovery after Surgery (ERAS) perioperative program between March 2013 and April 2017. The numeric rating scale (NRS) was used to estimate maximum pain. Logistic regression was used to model associations with the type of surgery, age, gender, and comorbidities. RESULTS The cohort comprised 434 of 459 eligible patients. On the day of surgery to postoperative day 3, 50-64% of patients reported moderate to severe pain (NRS 4-10). Postoperative pain was similar for open and minimally invasive rectal surgery, while patients undergoing minimally invasive colonic surgery experienced more pain on the day of surgery and less pain on postoperative days 2 and 3 vs. open colonic surgery. Younger age was associated with more pain every postoperative day and by 0.7 NRS/10 years (95% CI 0.5-0.9, P < 0.001) on the day of surgery, while having diabetes type 2 was associated with less postoperative pain by - 1.3 NRS (95% CI - 2.4 to - 0.2) on the day of surgery. CONCLUSIONS The majority, and young patients in particular, experience moderate to severe pain after open and minimally invasive colorectal surgery, despite following ERAS perioperative program. There is a need for effective and individualized analgesia after colorectal surgery, since the individual pain response to surgery is difficult to predict.

UI MeSH Term Description Entries
D007902 Length of Stay The period of confinement of a patient to a hospital or other health facility. Hospital Stay,Hospital Stays,Stay Length,Stay Lengths,Stay, Hospital,Stays, Hospital
D010149 Pain, Postoperative Pain during the period after surgery. Acute Post-operative Pain,Acute Postoperative Pain,Chronic Post-operative Pain,Chronic Post-surgical Pain,Chronic Postoperative Pain,Chronic Postsurgical Pain,Pain, Post-operative,Persistent Postsurgical Pain,Post-operative Pain,Post-operative Pain, Acute,Post-operative Pain, Chronic,Post-surgical Pain,Postoperative Pain, Acute,Postoperative Pain, Chronic,Postsurgical Pain,Postoperative Pain,Acute Post operative Pain,Chronic Post operative Pain,Chronic Post surgical Pain,Chronic Postsurgical Pains,Pain, Acute Post-operative,Pain, Acute Postoperative,Pain, Chronic Post-operative,Pain, Chronic Post-surgical,Pain, Chronic Postoperative,Pain, Chronic Postsurgical,Pain, Persistent Postsurgical,Pain, Post operative,Pain, Post-surgical,Pain, Postsurgical,Post operative Pain,Post operative Pain, Acute,Post operative Pain, Chronic,Post surgical Pain,Post-operative Pains,Post-surgical Pain, Chronic,Postsurgical Pain, Chronic,Postsurgical Pain, Persistent
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003107 Colorectal Surgery A surgical specialty concerned with the diagnosis and treatment of disorders and abnormalities of the COLON; RECTUM; and ANAL CANAL. Proctology,Colon Surgery Specialty,Colon and Rectal Surgery Specialty,Rectal Surgery Specialty,Specialty, Colon Surgery,Specialty, Rectal Surgery,Surgery Specialty, Colon,Surgery Specialty, Colon and Rectal,Surgery Specialty, Rectal,Surgery, Colorectal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000080482 Enhanced Recovery After Surgery A protocol of components related to preadmission, preoperative, intraoperative, and postoperative care. The protocol is implemented with the goal of improving patient recovery, facilitating earlier discharge from the hospital, and potentially reducing health care costs without increasing complications or hospital readmissions. The protocol components may contribute to minimizing, and/or improving the response to, physiological stress associated with surgery. Enhanced Postsurgical Recovery,Postsurgical Recoveries, Enhanced,Postsurgical Recovery, Enhanced,Recovery, Enhanced Postsurgical
D013505 Digestive System Surgical Procedures Surgery performed on the digestive system or its parts. Gastrointestinal Surgical Procedures,Digestive System Surgical Procedure,Gastrointestinal Surgical Procedure,Procedure, Digestive System Surgical,Procedure, Gastrointestinal Surgical,Procedures, Digestive System Surgical,Procedures, Gastrointestinal Surgical,Surgical Procedure, Digestive System,Surgical Procedure, Gastrointestinal,Surgical Procedures, Digestive System,Surgical Procedures, Gastrointestinal

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