[Factors affecting postoperative pain].
OBJECTIVE
To determine the influence on the intensity of postoperative pain of the following variables: sex, age, type of surgery, surgical approach, anesthetic technique and analgesia administered.


METHODS
Six hundred twenty-three hospitalized patients were enrolled from the units of general and digestive surgery, gynecology and obstetrics, ophthalmology, otorhinolaryngology, traumatology and orthopedics, and urology. Pain intensity was measured on a visual analog scale (VAS) when the patient left the post-anesthesia recovery ward (PARU) and 24 and 48 h after surgery, and on a verbal evaluation scale (VES) during the first and second days after surgery.


RESULTS
Gynecology is the department where the most pain is reported, both when the patient leaves the PARU (>= 4 for 56.6% of patients) and during the first day on the ward (71.3% of patients suffer pain of moderate or high intensity). The correlation of pain with duration of procedure was strongest in the urology and surgery units, with common variances of 32.3% and 23.4%, respectively. More pain is felt during open procedures in the traumatology and urology units, which is not the case in gynecology and surgery. Patients receiving general anesthesia leave the PARU with pain at 3.4 +/- 1.8 cm on the VAS scale, versus 1.3 +/- 1.6 cm for patients receiving locoregional anesthesia. Patients who received only ketorolac for pain in the PARU generally experienced less intense pain (2.5 +/- 2.0 cm) than did those who received metamizol (3.3 +/- 1.5 cm), morphine (4.0 +/- 1.8 cm) or tramadol (4.5 +/- 1.8 cm).


CONCLUSIONS
Surgical department, surgical approach, anesthetic technique and, finally, analgesic administered are the factors that determine the intensity of postoperative pain. These factors should therefore be taken into account when establishing treatment protocols to assure adequate control of postoperative pain. Neither sex nor age were determining factors for the intensity of postoperative pain.
Soler Company
E
E
Servicios de Farmacia Jefe del Servicio, Departamento de Farmacología. Universidad de Valencia, Spain.
Faus Soler
M
M
Montaner Abasolo
M
M
Morales Olivas
F
F
Martínez-Pons Navarro
V
V
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000758:Anesthesia; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology*; D012737:Sex Factors; D013514:Surgical Procedures, Operative