Risk factors for moderate and severe postoperative pain in patients undergoing percutaneous nephrolithotomy / 中华麻醉学杂志

ABSTRACT

Objective To determine the risk factors for moderate and severe postoperative pain in patients undergoing percutaneous nephrolithotomy.Methods Eighty-one patients of both sexes,aged 18-70 yr,with body mass index of 19-42 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,undergoing elective percutaneous nephrolithotomy under general anesthesia,were selected.When moderate and severe postoperative pain developed (visual analog scale score ≥ 4),dezocine 5 mg was intravenously injected with the dosing interval greater than 4 h.According to the occurrence of moderate and severe pain within 24 h after operation,the patients were divided into moderate and severe pain group and non-moderate and severe pain group.The age,sex,American Society of Anesthesiologists physical status,body mass index,preoperative abnormality of creatinine,urinary leukocyte,urinary bacteria,surgical site,severity of hydronephrosis,the number of affected renal calyx,CT value of stones,length of puncture channel,operation time,the number of postoperative drainage tube and residual stones were collected.Multivariate logistic regression analysis was performed to stratify the risk factors for moderate and severe postoperative pain.Results A total of 79 patients were included in this study.Among the 79 patients,47 patients developed moderate or severe pain,and the incidence was 59％.The results of multivariate logistic regression analysis showed that the number of preoperative affected renal calyx＞3,CT value of stones ＞ 1 000 and postoperative residual stones were independent risk factors for moderate and severe pain after percutaneous nephrolithotomy (P＜0.05).Conclusion The number of preoperative affected renal calyx＞3,CT value of stones ＞ 1 000 and postoperative residual stones are independent risk factors for moderate and severe postoperative pain in the patients undergoing percutaneous nephrolithotomy.