Correlation Between Pain Intensity and Quality of Recovery After Video-Assisted Thoracic Surgery for Lung Cancer Resection

• Published in: Journal of pain research 2023-09, Vol.16, p.3343-3352
• Main Authors: Yoon, Soo-Hyuk, Bae, Jinyoung, Yoon, Susie, Na, Kwon Joong, Lee, Ho-Jin
• Format: Article
• Language: English
• Subjects: Analysis; Care and treatment; Lung cancer; Medical research; Medicine, Experimental; Original Research; Pain; Palonosetron; patient-reported outcome measures; perioperative care; perioperative medicine; postoperative; Remifentanil; thoracic surgery; video-assisted
• ISSN: 1178-7090; 1178-7090
• DOI: 10.2147/JPR.S426570

Purpose: The Quality of Recovery-15 (QoR-15) questionnaire provides a multifaceted assessment of postoperative recovery, and the resulting score is recommended as an endpoint in clinical studies focused on postoperative pain. We aimed to investigate the correlation between the QoR-15 score and postoperative pain intensity in surgical patients. Patients and Methods: Adult patients who underwent video-assisted thoracoscopic surgery (VATS) for lung cancer resection and were enrolled in a prospective registry or in a previous prospective study were included in this study. Baseline and perioperative data, including the results of assessment using the Korean version of the QoR-15 (QoR-15K) questionnaire at 48 hours postoperatively, were collected from the database. Correlations between the QoR-15K total score, questionnaire dimensions, and postoperative pain intensity at 48 hours postoperatively were determined using the Spearman correlation coefficient ([rho]). Results: We analyzed a total of 137 eligible patients. Significant negative correlations were noted between the QoR-15K total score and pain intensity at rest ([rho] = -0.45, 95% confidence interval [CI]: -0.57 - -0.31, P < 0.001) and during coughing ([rho] = -0.55, 95% CI: -0.65 - -0.42, P < 0.001) at 48 hours postoperatively. The pain dimension and pain intensity at 48 hours postoperatively showed significant correlations with physical comfort, emotional state, and physical independence dimensions. Multivariable logistic regression revealed a significant negative association between the pain score at 24 hours postoperatively and good or excellent postoperative recovery. Conclusion: The results support the impact of postoperative pain on the overall postoperative quality of recovery in patients who underwent VATS for lung cancer resection. Moreover, the QoR-15K score may be considered as a primary endpoint in clinical studies on postoperative pain control. Keywords: pain, postoperative, patient-reported outcome measures, perioperative care, perioperative medicine, thoracic surgery, video-assisted