Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
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Factors Related to Persistent Postoperative Pain after Cardiac Surgery: A Systematic Review and Meta-Analysis

심장수술 후 지속적 통증의 관련 요인: 체계적 문헌고찰 및 메타분석

  • Received : 2019.07.02
  • Accepted : 2020.01.21
  • Published : 2020.04.30
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Abstract

Purpose: This study aimed at identifying factors related to persistent postoperative pain after cardiac surgery and estimating their effect sizes. Methods: The literature search and selection was conducted in four different databases (CINAHL, Cochrane Library, PubMed, and PQDT) using the Preferred Reporting Items for Systematic Review and Meta-Analysis Statement. A total of 14 studies met the inclusion criteria and were systematically reviewed. For the meta-analysis, R was used to analyze 30 effect sizes of for both individual and operative factors as well as publication biases from a total of nine studies. Results: The meta-analysis revealed that persistent postoperative pain after cardiac surgery was related to one individual factor (gender) and two operative factors (acute postoperative pain and use of the internal mammary artery). Operative factors (OR=5.26) had a larger effect size than individual factors (OR=1.53). Conclusion: Female gender, acute pain after surgery, and use of the internal mammary artery are related factors to persistent postoperative pain. The development of interventions focusing on modifiable related factors, such as acute postoperative pain, may help to minimize or prevent PPP after cardiac surgery.

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References

  1. Kehlet H, Edwards RR, Brennan T. Persistent postsurgical pain: Pathogenic mechanisms and preventive strategies. In: Raja SN, Sommer CL, editors. Pain 2014: Refresher courses. Proceedings of the 15th World Congress on Pain; 2012 Aug 27-31; Milan, Italy. Seattle (WA): IASP Press; 2014. p. 113-123.
  2. Richebe P, Capdevila X, Rivat C. Persistent postsurgical pain: Pathophysiology and preventative pharmacologic considerations. Anesthesiology. 2018;129(3):590-607. https://doi.org/10.1097/ALN.0000000000002238
  3. Chapman CR, Vierck CJ. The transition of acute postoperative pain to chronic pain: An integrative overview of research on mechanisms. The Journal of Pain. 2017;18(4):359.e1-359.e38. https://doi.org/10.1016/j.jpain.2016.11.004
  4. D'Agostino RS, Jacobs JP, Badhwar V, Fernandez FG, Paone G, Wormuth DW, et al. The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2018 update on outcomes and quality. The Annals of Thoracic Surgery. 2018;105(1):15-23. https://doi.org/10.1016/j.athoracsur.2017.10.035
  5. Choiniere M, Watt-Watson J, Victor JC, Baskett RJ, Bussieres JS, Carrier M, et al. Prevalence of and risk factors for persistent postoperative nonanginal pain after cardiac surgery: A 2-year prospective multicentre study. Canadian Medical Association Journal. 2014;186(7):E213-E223. https://doi.org/10.1503/cmaj.131012
  6. Turan A, Belley-Cote EP, Vincent J, Sessler DI, Devereaux PJ, Yusuf S, et al. Methylprednisolone does not reduce persistent pain after cardiac surgery. Anesthesiology. 2015;123(6):1404-1410. https://doi.org/10.1097/ALN.0000000000000915
  7. Setala P, Kalliomaki ML, Jarvela K, Huhtala H, Sisto T, Puolakka P. Postoperative hyperalgesia does not predict persistent post-sternotomy pain; observational study based on clinical examination. Acta Anaesthesiologica Scandinavica. 2016;60(4):520-528. https://doi.org/10.1111/aas.12659
  8. Mazzeffi M, Khelemsky Y. Poststernotomy pain: A clinical review. Journal of Cardiothoracic and Vascular Anesthesia. 2011;25(6):1163-1178. https://doi.org/10.1053/j.jvca.2011.08.001
  9. Homma T, Doki Y, Yamamoto Y, Ojima T, Shimada Y, Kitamura N, et al. Risk factors of neuropathic pain after thoracic surgery. Journal of Thoracic Disease. 2018;10(5):2898-2907. https://doi.org/10.21037/jtd.2018.05.25
  10. Guimaraes-Pereira L, Farinha F, Azevedo L, Abelha F, Castro-Lopes J. Persistent postoperative pain after cardiac surgery: Incidence, characterization, associated factors and its impact in quality of life. European Journal of Pain. 2016;20(9):1433-1442. https://doi.org/10.1002/ejp.866
  11. Boogaard S, Heymans MW, de Vet HC, Peters ML, Loer SA, Zuurmond WW, et al. Predictors of persistent neuropathic pain--a systematic review. Pain Physician. 2015;18(5):433-457.
  12. Cogan J. Pain management after cardiac surgery. Seminars in Cardiothoracic and Vascular Anesthesia. 2010;14(3):201-204. https://doi.org/10.1177/1089253210378401
  13. Sethares KA, Chin E, Costa I. Pain intensity, interference and patient pain management strategies the first 12 weeks after coronary artery bypass graft surgery. Applied Nursing Research. 2013;26(4):174-179. https://doi.org/10.1016/j.apnr.2013.07.005
  14. Gjeilo KH, Klepstad P, Wahba A, Lydersen S, Stenseth R. Chronic pain after cardiac surgery: A prospective study. Acta Anaesthesiologica Scandinavica. 2010;54(1):70-78. https://doi.org/10.1111/j.1399-6576.2009.02097.x
  15. Reddi D, Curran N. Chronic pain after surgery: Pathophysiology, risk factors and prevention. Postgraduate Medical Journal. 2014;90(1062):222-227; quiz 226. https://doi.org/10.1136/postgradmedj-2013-132215
  16. Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Introduction to meta-analysis. Chichester: John Wiley & Sons; 2009. p. 1-421.
  17. van Gulik L, Janssen LI, Ahlers SJ, Bruins P, Driessen AH, van Boven WJ, et al. Risk factors for chronic thoracic pain after cardiac surgery via sternotomy. European Journal of Cardiothoracic Surgery. 2011;40(6):1309-1313. https://doi.org/10.1016/j.ejcts.2011.03.039
  18. van Leersum NJ, van Leersum RL, Verwey HF, Klautz RJ. Pain symptoms accompanying chronic poststernotomy pain: A pilot study. Pain Medicine. 2010;11(11):1628-1634. https://doi.org/10.1111/j.1526-4637.2010.00975.x
  19. Bjornnes AK, Parry M, Lie I, Fagerland MW, Watt-Watson J, Rustoen T, et al. Pain experiences of men and women after cardiac surgery. Journal of Clinical Nursing. 2016;25(19-20):3058-3068. https://doi.org/10.1111/jocn.13329
  20. Lee W, Yan YY, Jensen MP, Shun SC, Lin YK, Tsai TP, et al. Predictors and patterns of chronic pain three months after cardiac surgery in Taiwan. Pain Medicine. 2010;11(12):1849-1858. https://doi.org/10.1111/j.1526-4637.2010.00976.x
  21. Momeni M, De Kock M, Lavand'homme P, Watremez C, Van Dyck M, Baele P. Abnormal sensations evoked over the chest and persistent peri-incisional chest pain after cardiac surgery. Acta Anaesthesiologica Belgica. 2010;61(2):55-62.
  22. Costa MA, Trentini CA, Schafranski MD, Pipino O, Gomes RZ, Reis ES. Factors associated with the development of chronic post-sternotomy pain: A case-control study. Brazilian Journal of Cardiovascular Surgery. 2015;30(5):552-556. https://doi.org/10.5935/1678-9741.20150059
  23. Page MG, Watt-Watson J, Choiniere M. Do depression and anxiety profiles over time predict persistent post-surgical pain? A study in cardiac surgery patients. European Journal of Pain. 2017;21(6):965-976. https://doi.org/10.1002/ejp.998
  24. Pezzella AT. Global aspects of cardiothoracic surgery with focus on developing countries. Asian Cardiovascular & Thoracic Annals. 2010;18(3):299-310. https://doi.org/10.1177/0218492310370060
  25. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Annals of Internal Medicine. 2009;151(4):264-269, W64. https://doi.org/10.7326/0003-4819-151-4-200908180-00135
  26. Eyler AE, Wilcox S, Matson-Koffman D, Evenson KR, Sanderson B, Thompson J, et al. Correlates of physical activity among women from diverse racial/ethnic groups. Journal of Women's Health & Gender-Based Medicine. 2002;11(3):239-253. https://doi.org/10.1089/152460902753668448
  27. Cleeland CS, Ryan KM. Pain assessment: Global use of the Brief Pain Inventory. Annals of the Academy of Medicine, Singapore. 1994;23(2):129-138.
  28. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions. New York: John Wiley & Sons; 2011. p. 1-672.
  29. Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses [Internet]. Ottawa: Ottawa Hospital Research Institute; c2011 [cited 2019 Apr 01]. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm.
  30. Baek YM. Analysis of social science data using R. Seoul: Communication Books; 2015. p. 1-364.
  31. Hwang SD. Meta-analysis. Seoul: Hakjisa; 2014. p. 1-320.
  32. Duval S, Tweedie R. Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56(2):455-463. https://doi.org/10.1111/j.0006-341x.2000.00455.x
  33. Wang L, Guyatt GH, Kennedy SA, Romerosa B, Kwon HY, Kaushal A, et al. Predictors of persistent pain after breast cancer surgery: A systematic review and meta-analysis of observational studies. Canadian Medical Association Journal. 2016;188(14):E352-E361. https://doi.org/10.1503/cmaj.151276
  34. Mei WJ, Fei LH, Yan JH. Acute post surgical pain may result in chronic post surgical pain: A systemic review and meta analysis. Pakistan Journal of Medical Sciences. 2015;31(4):833-836. https://doi.org/10.12669/pjms.314.7555
  35. Wylde V, Dennis J, Beswick AD, Bruce J, Eccleston C, Howells N, et al. Systematic review of management of chronic pain after surgery. The British Journal of Surgery. 2017;104(10):1293-1306. https://doi.org/10.1002/bjs.10601
  36. Maas AHEM, Appelman YEA. Gender differences in coronary heart disease. Netherlands Heart Journal. 2010;18(12):598-602. https://doi.org/10.1007/s12471-010-0841-y
  37. Prata J, Ramos S, Martins AQ, Rocha-Goncalves F, Coelho R. Women with coronary artery disease: Do psychosocial factors contribute to a higher cardiovascular risk? Cardiology in Review. 2014;22(1):25-29. https://doi.org/10.1097/CRD.0b013e31829e852b
  38. Cornally N, McCarthy G. Help-seeking behaviour for the treatment of chronic pain. British Journal of Community Nursing. 2011;16(2):90-98. https://doi.org/10.12968/bjcn.2011.16.2.90
  39. Aslan FE, Korkmaz FD, Karabacak U. Pain in cardiac surgery and the nursing approach. Turkish Journal of Thoracic and Cardiovascular Surgery. 2012;20(1):172-176. https://doi.org/10.5606/tgkdc.dergisi.2012.036
  40. Achanta G. Comorbidities as predictors of pain outcomes after primary and revision total knee arthroplasty [Internet]. Rockville (MD): Agency for Healthcare Research and Quality; c2017 [cited 2019 Apr 10]. Available from: https://www.ahrq.gov/chain/research-tools/featured-certs/comorbidities-as-predictors.html.
  41. Bierman A. Shifting focus: Non-opioid strategies for chronic pain [Internet]. Rockville (MD): Agency for Healthcare Research and Quality; c2018 [cited 2019 Apr 10]. Available from: https://www.ahrq.gov/news/blog/ahrqviews/non-opioid-chronic-pain.html.