A Study On Relationship And Influential Factors Of Postoperative Pain And Anxiety In The Patients With Abdominal Operation

Objective:To identify the trend of variation and relationship of postoperative pain and anxiety in the patients with abdominal operation by analyzing their postoperative and pain anxiety;To explore the effect of analgesic techniques on anxiety and postoperative pain in the patients with abdominal operation;To explore the factors influenting postoperative pain and anxiety in the patients with abdominal operation.Methods:120 patients with selective hepatobiliary operation were grouped to PCIA group and control group by simple randomization grouping.The PCIA group was given venous PCA continually in 48h of postoperation,The control group was anaesthetized by traditional method. All subjects were asked to fill in the questionnaire-bags of pain and anxiety in preoperation and different time of postoperation.These questionnaires included:The Patients of Operation General Information Survey,Visual Analogue Scale(VAS),Short-form of McGill Pain Questionnaire(SF-MPQ),State Trait Anxiety Inventory(STAI),Perceived Social Support Scale(PSSS),Eysenek Personalily Questionnaire(EPQ). Descriptive analysis,t-test,Chi-squared test,repeated measures analysis of variance,single factor analysis of variance,Pearson correlation analysis and multiple linear stepwise regression analysis were performed by using Statistical Package for Social Science(SPSS)13.0.Results:1.The scores of preoperative anxiety of patients with abdominal operation were higher than norm(P＜0.001);2.There were significant differences of the scores of pain and anxiety in different time of postoperation in patients(P＜0.001,P＜0.001);3.There were significant differences of the scores of pain at 2h and 12h of postoperation between PCIA group and control group(P＜0.05,P＜0.01),and there were significant differences of the scores of anxiety at 12h of postoperation between PCIA group and control group(P＜0.01);4.The score of preoperative anxiety was positively correlated with the scores of postoperative pain of different time(except 1W of postoperation),The scores of pain at 12h and 72h of postoperation were positively correlated with the scores of anxiety at 12h and 72h of postoperation;5.There were significant differences of the effects of different analgesic techniques on the scores of pain at 2h,12h,24h and 48h of postoperation,and there were significant differences of the effects of different analgesic techniques on the scores of anxiety at 12h of postoperation;6.The result of multiple linear stepwise regression analysis showed that the factors which influenced the scores of pain at 2h,12h,24h and 48h of postoperation were: preoperative state anxiety(b′=0.299,b′=0.255,b′=0.182,b′=0.337),analgesic techniques(b′=0.351,b′=0.244,b′=0.182,b′=0.193),The factors which influenced the scores of pain at 12h,24h of postoperation were:EPQ-P(b′=0.309,b′=0.205);7.The result of multiple linear stepwise regression analysis showed that the factors which influenced patients' scores of anxiety in different time of postoperation respectively were:12h of postoperation:analgesic techniques(b′=0.365),occupations(b′=-0.309),PSSS(b′=-0.273),24h of postoperation: PRI-S(b′=0.411),occupations(b′=-0.199),48h of postoperation:PRI-S(b′=0.330).Conclusions:1.The level of pain and anxiety of the patients in 12h of postoperation are the highest,and with the passage of postoperative time,both patients' level of pain and anxiety both descend;2.The level of preoperative anxiety influences the level of postoperative pain, patients with higher level of preoperative anxiety show higher level of postoperative pain;postoperative pain and anxiety influence each other, patients with higher level of postoperative pain show higher level of anxiety;3.Analgesic techniques can influence pain and anxiety of the patients with abdominal operation,The levels of pain and anxiety of PCIA group are lower than control group;4.The main factors influencing postoperative pain are:the level of preoperative anxiety and psychoticism tendency;5.The main factors influencing postoperative anxiety are: social support,occupations and pain reaction.