Postoperative pain investigation under the protocol of enhanced recovery after abdominal surgery: incidence and risk factors

Postoperative pain (PP) is a great obstacle for the application of enhanced recovery after surgery (ERAS) programs. The current study explored incidence and risk factors of PP under the ERAS protocol. From December 2016 to January 2017, this study retrospectively reviewed 80 patients that completed the ERAS program for abdominal surgery. A visual analog scale (VAS) score was applied to evaluate pain perception within the first three postoperative days, with VAS scores >= 5 considered as moderate-to-severe pain. Patients were divided with cumulative VAS>2 and VAS <= 2 scores into the pain group and non-pain group, respectively. PP incidence was 63.8%, with 6.3% for moderate-to-severe pain. PP was associated with prolonged hospital stay (5 vs. 3 days, P=0.018) and increased hospital costs ($5,685.3 vs. $3,.708.0, P=0.023). Gender (P=0.033) and malignancy (P=0.027) were independent risk factors of PP. PP remains a challenging problem of ERAS. Pain relief measures should be applied for female or malignant patients, aiming to promote enhanced recovery.