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Management of Postoperative Pain

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Anesthesiology".

Deadline for manuscript submissions: closed (10 October 2018) | Viewed by 17553

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Special Issue Editor

Prof. Dr. Sang-Hwan Do

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Guest Editor

Department of Anesthesiology & Pain Medicine, Seoul National University, Bundang Hospital, Seoul, Republic of Korea
Interests: magnesium; postoperative pain; postoperative nausea and vomiting

Special Issue Information

Dear Colleagues,

Patients usually suffer after operation. Acute postoperative pain is one of the most feared complications by the patients. Postoperative pain, especially when poorly controlled, results in harmful effects such as adverse physiologic responses. Besides, a variable portion (5%–85%) of acute postoperative pain converts to chronic pain, which is a devastating outcome after surgery. Because chronic pain is difficult to treat, and is often persistent, efforts should be made to prevent the development of chronic pain after surgery. To do so, pathophysiology of postoperative pain (acute or chronic) should be understood, a variety of treatment options should be evaluated, and preventive measures of chronic postoperative pain need to be established. Proper managements of postoperative pain are essential to safe and rapid recovery after operation. Please join us in presenting this Special Issue on the up-to-date research currently being performed on postoperative pain in different academic fields to improve postoperative care of surgical patients.

Prof. Dr. Sang-Hwan Do
Guest Editor

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Keywords

Postoperative pain
Postoperative analgesia
Chronic postsurgical pain
Pathophysiology
Prevention

Published Papers (5 papers)

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Research

9 pages, 539 KiB

Open AccessArticle

Effect of Size and Location of Nevi on Postoperative Pain and Emergence Agitation in Children Undergoing Nevi Excision

by Jin-Soo Kim, Hye Sun Lee, Dong Ha Park, Suhyun Seok, Tae Kwang Kim, Hye Seon Lee and Ji Eun Kim

J. Clin. Med. 2019, 8(1), 106; https://doi.org/10.3390/jcm8010106 - 17 Jan 2019

Cited by 4 | Viewed by 2673

Abstract

Congenital melanocytic nevi need surgical excisions. However, the effect of the size and location of the nevi on pain and emergence agitation have yet to be studied. The objective of this study was to evaluate (1) the ideal parameter of the nevus size and (2) the effects of the size and location of the nevus on pain and emergence agitation. This observational study enrolled 100 children scheduled for an excision of a nevus under sevoflurane anesthesia. The parameters of the nevus size included the long diameter, the area before resection, the area of resection, and the proportion (the area of resection/total body surface). The nevus locations included the trunk, face, scalp, and extremities. The proportion of the nevi was the most ideal parameter in evaluating the pain and emergence agitation. A large size showed a higher emergence agitation than a small size (median (range); 6 (0–20) in small groups vs. 12.5 (0–20) in large groups, p = 0.021). However, the pain was comparable. The nevus location did not influence pain or emergence agitation. In a multivariate regression analysis, a younger age and an extensive excision were associated with higher pain and emergence agitation. In conclusion, large nevi induced more severe emergence agitation. However, the nevus location did not affect the outcome. In addition, a younger age was associated with pain and emergence agitation. Clinicians need to consider the proportion of nevi when managing children undergoing a nevus excision. Full article

(This article belongs to the Special Issue Management of Postoperative Pain)

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13 pages, 3446 KiB

Open AccessArticle

Association between Modified Body Mass Index and 30-Day and 1-Year Mortality after Intensive Care Unit Admission: A Retrospective Cohort Study

by Tak Kyu Oh, Jaebong Lee, Yeon Joo Lee, Jung-Won Hwang, Sang-Hwan Do, Young-Tae Jeon and In-Ae Song

J. Clin. Med. 2018, 7(4), 81; https://doi.org/10.3390/jcm7040081 - 13 Apr 2018

Cited by 6 | Viewed by 3634

Abstract

Because conventional body mass index (cBMI) does not reflect fluid accumulation, modified BMI (mBMI, serum albumin multiplied by cBMI) is a more accurate measure of malnutrition status. This study aimed to determine whether mortality after intensive care unit (ICU) admission was associated with cBMI, mBMI, and/or serum albumin levels. The medical records of patients who were admitted to a tertiary hospital ICU between 1 January 2012 and 31 July 2016 were retrospectively reviewed. In total, 6169 ICU-admitted patients were included in the analyses. Multivariate Cox regression analyses revealed that low cBMI, mBMI and albumin level were significantly associated with 30-day and 1-year mortality after ICU admission (hazard ratio < 1.0, p < 0.05). The adjusted area under the curve (AUC) of mBMI for 1-year mortality was significantly higher than that of cBMI (p < 0.001), but not significantly different from that of albumin level (p = 0.098). Low values of mBMI, cBMI and albumin were independently associated with 30-day and 1-year mortality after ICU admission. Combining cBMI and albumin (mBMI) did not increase the validity of the AUC of albumin for 1-year mortality after ICU admission. Our study showed that serum albumin alone, rather than mBMI (combining cBMI), is recommended in predicting mortality among ICU patients. Full article

(This article belongs to the Special Issue Management of Postoperative Pain)

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11 pages, 194 KiB

Open AccessArticle

Association between Socioeconomic Status and 30-Day and One-Year All-Cause Mortality after Surgery in South Korea

by Tak Kyu Oh, Kooknam Kim, Sang-Hwan Do, Jung-Won Hwang and Young-Tae Jeon

J. Clin. Med. 2018, 7(3), 52; https://doi.org/10.3390/jcm7030052 - 10 Mar 2018

Cited by 1 | Viewed by 2756

Abstract

Preoperative socioeconomic status (SES) is associated with outcomes after surgery, although the effect on mortality may vary according to region. This retrospective study evaluated patients who underwent elective surgery at a tertiary hospital from 2011 to 2015 in South Korea. Preoperative SES factors (education, religion, marital status, and occupation) were evaluated for their association with 30-day and one-year all-cause mortality. The final analysis included 80,969 patients who were ≥30 years old, with 30-day mortality detected in 339 cases (0.4%) and one-year mortality detected in 2687 cases (3.3%). As compared to never-married patients, those who were married or cohabitating (odds ratio (OR): 0.678, 95% confidence interval (CI): 0.462–0.995) and those divorced or separated (OR: 0.573, 95% CI: 0.359–0.917) had a lower risk of 30-day mortality after surgery. Similarly, the risk of one-year mortality after surgery was lower among married or cohabitating patients (OR: 0.857, 95% CI: 0.746–0.983) than it was for those who had never married. Moreover, as compared to nonreligious patients, Protestant patients had a decreased risk of 30-day mortality after surgery (OR: 0.642, 95% CI: 0.476–0.866). The present study revealed that marital status and religious affiliation are associated with risk of 30-day and one-year all-cause mortality after surgery. Full article

(This article belongs to the Special Issue Management of Postoperative Pain)

9 pages, 324 KiB

Open AccessArticle

C-Reactive Protein to Albumin Ratio Predicts 30-Day and 1-Year Mortality in Postoperative Patients after Admission to the Intensive Care Unit

by Tak Kyu Oh, Eunjeong Ji, Hyo-seok Na, Byunghun Min, Young-Tae Jeon, Sang-Hwan Do, In-Ae Song, Hee-Pyoung Park and Jung-Won Hwang

J. Clin. Med. 2018, 7(3), 39; https://doi.org/10.3390/jcm7030039 - 26 Feb 2018

Cited by 33 | Viewed by 4555

Abstract

C-reactive protein and albumin are associated with poor outcomes in critically ill patients. This study aimed to investigate the significance of the C-reactive protein/albumin (CRP/ALB) ratio as a novel prognostic factor for 30-day or 1-year mortality after admission to the postoperative intensive care unit (ICU). This retrospective study was conducted by examining the medical records of postoperative patients aged 19 years or older admitted to the ICU at a tertiary care hospital from January 2007 to July 2016. This study included data on 11,832 postoperative patients in the analysis. The cut-off value of the CRP/ALB ratio was set at 1.75 and 1.58 for 30-day and 1-year mortality after ICU admission, respectively. In postoperative patients with a high CRP/ALB ratio (>1.75 or >1.58), the probability of death within 30 days or 1 year after ICU admission were 30% or 43% higher than that in the group with the least CRP/ALB ratio, respectively (≤1.75 or ≤1.58)(p < 0.05). This study found the CRP/ALB ratio measured immediately after ICU admission to be an independent risk factor for 30-day and 1-year mortality in postoperative patients admitted to the ICU. Full article

(This article belongs to the Special Issue Management of Postoperative Pain)

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10 pages, 1169 KiB

Open AccessArticle

Long-Term Oncologic Outcomes, Opioid Use, and Complications after Esophageal Cancer Surgery

by Tak Kyu Oh, Kwhanmien Kim, Sang Hoon Jheon, Sang-Hwan Do, Jung-Won Hwang, Young-Tae Jeon, Kooknam Kim and In-Ae Song

J. Clin. Med. 2018, 7(2), 33; https://doi.org/10.3390/jcm7020033 - 19 Feb 2018

Cited by 12 | Viewed by 3302

Abstract

Effective and adequate opioid use and prevention of postoperative complications are important for enhanced recovery after surgery. We examined the effects of postoperative opioid use and postoperative complications on overall survival and recurrence-free survival after esophageal cancer surgery. This retrospective cohort study analyzed the records of patients diagnosed with esophageal cancer who underwent the Ivor Lewis operation between January 2005 and December 2011. We collected data on total opioid use for 8 days postoperatively, as well as information on postoperative complications (Clavien-Dindo classification). One hundred and twenty-one patients were included in the final analysis. Total opioid use was not significantly associated with overall survival (p = 0.520) and recurrence-free survival (p = 0.818). In contrast, the hazard ratio of postoperative overall survival was significantly higher with respect to Clavien-Dindo classification 1–2 (hazard ratio: 2.009, p = 0.046), 3a–3b (hazard ratio: 5.759, p < 0.001), and 4a–5 (hazard ratio: 3.982, p = 0.020) complications compared to no complications. Additionally, the hazard ratio of the recurrence-free survival was significantly higher in class 1–2 complications (hazard ratio: 2.336, p = 0.028) compared to none. Our study demonstrates that postoperative opioid use is not associated with survival and recurrence-free survival after esophageal cancer surgery, while postoperative complications may increase the hazard ratio for survival and recurrence-free survival. Full article

(This article belongs to the Special Issue Management of Postoperative Pain)

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