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

Soo-Hyuk Yoon; Jinyoung Bae; Susie Yoon; Kwon Joong Na; Ho-Jin Lee

doi:10.2147/JPR.S426570

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

J Pain Res. 2023 Oct 2:16:3343-3352. doi: 10.2147/JPR.S426570. eCollection 2023.

Authors

Soo-Hyuk Yoon^#¹, Jinyoung Bae^#², Susie Yoon^{1

3}, Kwon Joong Na^{4

5}, Ho-Jin Lee^{1

3}

Affiliations

¹ Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
² Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.
³ Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
⁴ Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Republic of Korea.
⁵ Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.

^# Contributed equally.

Abstract

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 (ρ).

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 (ρ = -0.45, 95% confidence interval [CI]: -0.57 - -0.31, P < 0.001) and during coughing (ρ = -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; patient-reported outcome measures; perioperative care; perioperative medicine; postoperative; thoracic surgery; video-assisted.