{"title":"日间手术后急性疼痛的预测因素：荟萃分析。","authors":"Hanqing Zhang, Xinglian Gao","doi":"10.2147/JPR.S538046","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aims to provide evidence-based recommendations for optimizing postoperative pain management and enhancing recovery efficiency by identifying key predictors of acute postoperative pain in day surgery patients.</p><p><strong>Background: </strong>As day surgery becomes more widespread, effective management of acute postoperative pain is crucial for successful recovery. A variety of studies have explored factors influencing postoperative acute pain. This study synthesizes existing evidence through a meta-analysis to clarify the primary predictors.</p><p><strong>Methods: </strong>A comprehensive search was performed across multiple databases, including PubMed, CINAHL, Scopus, Web of Science, EMBASE, the Cochrane Library, and CNKI, to identify clinical studies examining factors associated with acute postoperative pain following day surgery. The search encompassed all relevant publications up to January 30, 2025. The systematic review and meta-analysis employed a fixed-effects model to analyze the data, with a random-effects model applied in cases of significant heterogeneity.</p><p><strong>Results: </strong>Ten studies involving 11,865 patients were included. Significant predictors of acute postoperative pain, including: insufficient use of analgesics (OR = 2.12, <i>P</i> < 0.00001), age < 45 years (OR = 2.88, <i>P</i> < 0.00001), open surgery (OR = 5.05, <i>P</i> < 0.00001), education level ≤ middle school (OR = 2.06, <i>P</i> = 0.0001), preoperative fear and anxiety (OR = 2.18, <i>P</i> < 0.00001), higher preoperative pain expectation (OR = 1.74, <i>P</i> < 0.00001), and general anesthesia (OR = 1.91, <i>P</i> < 0.0001).</p><p><strong>Conclusion: </strong>This study identified the main predictors of acute postoperative pain in day surgery, suggesting these factors should be incorporated into clinical assessments to optimize pain management and recovery. The main risk factors include analgesic usage, age, surgery type, education level, preoperative fear and anxiety, pain expectation, and anesthesia type. Effective preoperative management of these factors may reduce postoperative pain and enhance recovery.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"5249-5263"},"PeriodicalIF":2.5000,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515452/pdf/","citationCount":"0","resultStr":"{\"title\":\"Predictive Factors of Acute Pain After Day Surgery: A Meta-Analysis.\",\"authors\":\"Hanqing Zhang, Xinglian Gao\",\"doi\":\"10.2147/JPR.S538046\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aims to provide evidence-based recommendations for optimizing postoperative pain management and enhancing recovery efficiency by identifying key predictors of acute postoperative pain in day surgery patients.</p><p><strong>Background: </strong>As day surgery becomes more widespread, effective management of acute postoperative pain is crucial for successful recovery. A variety of studies have explored factors influencing postoperative acute pain. This study synthesizes existing evidence through a meta-analysis to clarify the primary predictors.</p><p><strong>Methods: </strong>A comprehensive search was performed across multiple databases, including PubMed, CINAHL, Scopus, Web of Science, EMBASE, the Cochrane Library, and CNKI, to identify clinical studies examining factors associated with acute postoperative pain following day surgery. The search encompassed all relevant publications up to January 30, 2025. The systematic review and meta-analysis employed a fixed-effects model to analyze the data, with a random-effects model applied in cases of significant heterogeneity.</p><p><strong>Results: </strong>Ten studies involving 11,865 patients were included. Significant predictors of acute postoperative pain, including: insufficient use of analgesics (OR = 2.12, <i>P</i> < 0.00001), age < 45 years (OR = 2.88, <i>P</i> < 0.00001), open surgery (OR = 5.05, <i>P</i> < 0.00001), education level ≤ middle school (OR = 2.06, <i>P</i> = 0.0001), preoperative fear and anxiety (OR = 2.18, <i>P</i> < 0.00001), higher preoperative pain expectation (OR = 1.74, <i>P</i> < 0.00001), and general anesthesia (OR = 1.91, <i>P</i> < 0.0001).</p><p><strong>Conclusion: </strong>This study identified the main predictors of acute postoperative pain in day surgery, suggesting these factors should be incorporated into clinical assessments to optimize pain management and recovery. The main risk factors include analgesic usage, age, surgery type, education level, preoperative fear and anxiety, pain expectation, and anesthesia type. Effective preoperative management of these factors may reduce postoperative pain and enhance recovery.</p>\",\"PeriodicalId\":16661,\"journal\":{\"name\":\"Journal of Pain Research\",\"volume\":\"18 \",\"pages\":\"5249-5263\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-10-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515452/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Pain Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/JPR.S538046\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pain Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/JPR.S538046","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：本研究旨在通过识别日间手术患者急性术后疼痛的关键预测因素，为优化术后疼痛管理和提高恢复效率提供循证建议。背景：随着日间手术的普及，对术后急性疼痛的有效管理是成功恢复的关键。各种研究探讨了影响术后急性疼痛的因素。本研究通过荟萃分析综合现有证据来澄清主要预测因素。方法：对多个数据库进行综合检索，包括PubMed、CINAHL、Scopus、Web of Science、EMBASE、Cochrane Library和CNKI，以确定检查白天手术后急性术后疼痛相关因素的临床研究。检索包括截至2025年1月30日的所有相关出版物。系统评价和meta分析采用固定效应模型对数据进行分析，在异质性显著的情况下采用随机效应模型。结果：纳入10项研究，共11865例患者。急性术后疼痛的显著预测因素包括：镇痛药使用不足（OR = 2.12, P < 0.00001）、年龄< 45岁（OR = 2.88, P < 0.00001）、开放手术（OR = 5.05, P < 0.00001）、文化程度≤中学（OR = 2.06, P = 0.0001）、术前恐惧和焦虑（OR = 2.18, P < 0.00001）、术前较高的疼痛预期（OR = 1.74, P < 0.00001）、全身麻醉（OR = 1.91, P < 0.0001）。结论：本研究确定了日间手术急性术后疼痛的主要预测因素，建议将这些因素纳入临床评估，以优化疼痛管理和恢复。主要危险因素包括镇痛药的使用、年龄、手术类型、文化程度、术前恐惧和焦虑、疼痛预期和麻醉类型。有效的术前管理这些因素可以减少术后疼痛，促进康复。
Predictive Factors of Acute Pain After Day Surgery: A Meta-Analysis.
Objective: This study aims to provide evidence-based recommendations for optimizing postoperative pain management and enhancing recovery efficiency by identifying key predictors of acute postoperative pain in day surgery patients.
Background: As day surgery becomes more widespread, effective management of acute postoperative pain is crucial for successful recovery. A variety of studies have explored factors influencing postoperative acute pain. This study synthesizes existing evidence through a meta-analysis to clarify the primary predictors.
Methods: A comprehensive search was performed across multiple databases, including PubMed, CINAHL, Scopus, Web of Science, EMBASE, the Cochrane Library, and CNKI, to identify clinical studies examining factors associated with acute postoperative pain following day surgery. The search encompassed all relevant publications up to January 30, 2025. The systematic review and meta-analysis employed a fixed-effects model to analyze the data, with a random-effects model applied in cases of significant heterogeneity.
Results: Ten studies involving 11,865 patients were included. Significant predictors of acute postoperative pain, including: insufficient use of analgesics (OR = 2.12, P < 0.00001), age < 45 years (OR = 2.88, P < 0.00001), open surgery (OR = 5.05, P < 0.00001), education level ≤ middle school (OR = 2.06, P = 0.0001), preoperative fear and anxiety (OR = 2.18, P < 0.00001), higher preoperative pain expectation (OR = 1.74, P < 0.00001), and general anesthesia (OR = 1.91, P < 0.0001).
Conclusion: This study identified the main predictors of acute postoperative pain in day surgery, suggesting these factors should be incorporated into clinical assessments to optimize pain management and recovery. The main risk factors include analgesic usage, age, surgery type, education level, preoperative fear and anxiety, pain expectation, and anesthesia type. Effective preoperative management of these factors may reduce postoperative pain and enhance recovery.
期刊介绍：
Journal of Pain Research is an international, peer-reviewed, open access journal that welcomes laboratory and clinical findings in the fields of pain research and the prevention and management of pain. Original research, reviews, symposium reports, hypothesis formation and commentaries are all considered for publication. Additionally, the journal now welcomes the submission of pain-policy-related editorials and commentaries, particularly in regard to ethical, regulatory, forensic, and other legal issues in pain medicine, and to the education of pain practitioners and researchers.
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