Influence factors of analgesic effect after coronary artery bypass grafting
Wu Xianhong
Meng Qianqian
Zhang Yu
Yu Yang
Wu Chuxiong
Abstract：Objective To analyze the factors affecting analgesic effect after coronary artery bypass grafting. Methods A total of 1 291 patients who underwent coronary artery bypass grafting in Beijing Anzhen Hospital,Capital Medical University from May 2017 to June 2018 were retrospectively analyzed. Postoperative 8,24,48 h Visual Analogue Scale(VAS) scores(VAS-8,VAS-24,VAS-48) were recorded. Relevant variables of analgesic effect included age,gender,body mass index,smoking history,drinking history,history of hypertension, history of diabetes, use of internal mammary artery, operative time, extracorporeal circulation and blood transfusion. Risk factors of VAS-48 were analyzed through single-factor analysis and multi-factor logistic regression. Results Among the 1 291 patients,influence factors associated with VAS-8 were history of diabetes, smoking and use of internal mammary artery(all P < 0.05); influence factors associated with VAS-24 were age, gender and drinking history in addition(all P < 0.05); influence factors of VAS-48 included all the significant factors of VAS-8 and VAS-24(all P < 0.01). Multivariate logistic regression showed that VAS-48 was positively related with VAS-8(coefficient of correlation = 0.081,P < 0.001) ,VAS-24(coefficient of correlation = 0.995,P <0.001) ,age < 55 years(coefficient of correlation = 0.161,P = 0.015) ,male(coefficient of correlation = 0.139, P = 0.045) ,smoking history(coefficient of correlation = 0.647,P < 0.001) and negatively related with age > 70 years(coefficient of correlation = -0.411,P < 0.001) ,diabetes history(coefficient of correlation = -0.308, P < 0.001) and operative time > 6 h (coefficient of correlation = -0.157,P = 0.013). Conclusions Risk factors of insufficient postoperative analgesia include age(< 55 years) ,male and smoking history. Advanced age (> 70 years) ,diabetes history and operative time(> 6 h) are negatively correlated with VAS-48. VAS-8 and VAS-24 are good predictors of VAS-48,suggesting that if early analgesia is not effective,multimodal analgesia should be initiated as early as possible to avoid chronic pain.
Keywords：Coronary artery bypass graftingCoronary heart diseasePatient-controlled analgesia
Publication Date：2019-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：4( 682-685 )