title: Pain characteristics and analgesic intake before and following cardiac surgery.
abstract: BACKGROUND
  Cardiac surgery is a common intervention that involves several pain-sensitive structures, and intense postoperative pain is a predictor of persistent pain.
  
  
  OBJECTIVE
  To describe pain characteristics (i.e. intensity, location, interference, relief) and analgesic intake preoperatively and across postoperative days 1 to 4 after cardiac surgery, and to explore associations between postoperative pain and demographic and clinical characteristics.
  
  
  METHODS
  Four hundred and sixteen patients (24% women) undergoing elective coronary artery bypass grafting and/or valve surgery were enrolled in a randomized controlled trial. Data were collected using standardized measures including the Brief Pain Inventory-short form. A linear mixed model analysis estimated the impact of sex, age, body mass index, analgesic intake and preoperative pain on postoperative worst pain ratings in the previous 24 hours from postoperative days 1 to 4 prior to discharge
  
  
  RESULTS
  Thirty-eight per cent of the cardiac surgery patients reported preoperative pain. Postoperative worst pain remained in the moderate to severe range for the majority of patients across day 1 (85%) to day 4 (57%), mainly around the chest incision area for the majority (70%). Mean oral morphine intake was 17 mg/24 h (day 1: 27mg; day 4: 10mg). Lower age, female sex, preoperative pain and analgesic intake had a statistically significant association with higher postoperative worst pain ratings.
  
  
  CONCLUSIONS
  Study findings demonstrated a high prevalence of moderate to severe pain after cardiac surgery and insufficient analgesic administration. Results indicated that patients were discharged from hospital with unrelieved pain and a potential risk for further postoperative complications.
authors.affiliation: Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Ullevål, Norway ann-kristin.bjornnes@hioa.no.
authors.forename: Ann Kristin
authors.initials: AK
authors.lastname: Bjørnnes
authors.affiliation: Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Ullevål, Norway Institute of Health and Society, University of Oslo, Norway.
authors.forename: Tone
authors.initials: T
authors.lastname: Rustøen
authors.affiliation: Department of Cardiothoracic Surgery, Oslo University Hospital, Ullevål, Norway.
authors.forename: Irene
authors.initials: I
authors.lastname: Lie
authors.affiliation: Lawrence S Bloomberg Faculty of Nursing, Senior Fellow, Massey College University of Toronto, Canada.
authors.forename: Judy
authors.initials: J
authors.lastname: Watt-Watson
authors.affiliation: Oslo and Akershus University College of Applied Sciences, Faculty of Health Sciences, Institute of Nursing, Norway.
authors.forename: Marit
authors.initials: M
authors.lastname: Leegaard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use*; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*
chemical_list: D000700:Analgesics
keywords: Cardiac surgery; analgesic intake; pain management; postoperative pain