Early Postoperative Pain After Cardiac Surgery

Postoperative pain after cardiac surgery is influenced by multiple patient-related, psychological, surgical, and perioperative factors. The relative contribution of these factors to early postoperative pain and related outcomes remains uncertain.

This retrospective observational cohort study will evaluate factors associated with early postoperative pain in adult patients who underwent open cardiac surgery, including coronary artery bypass grafting, valve surgery, or combined cardiac procedures. Existing medical records will be retrospectively reviewed.

The analysis will examine demographic characteristics, preoperative anxiety and depression, surgical characteristics, and perioperative factors in relation to early postoperative pain. Preoperative anxiety and depression will be evaluated using available Hospital Anxiety and Depression Scale (HADS) scores. Postoperative pain will be assessed using Numeric Rating Scale (NRS) measurements recorded during the first 24 hours after surgery. Postoperative nausea and vomiting and the requirement for additional rescue analgesia will also be evaluated as related postoperative outcomes.

Associations between these clinical and psychological factors and postoperative outcomes will be examined using appropriate statistical analyses. No study-specific treatment or intervention will be assigned to participants, as all study data will be obtained retrospectively from existing medical records.

Inclusion criteria

• Age ≥18 years
• Underwent open cardiac surgery, including coronary artery bypass grafting (CABG), valve surgery, or combined cardiac surgery
• Complete perioperative and postoperative pain data available in the medical records

Exclusion criteria

• Incomplete medical records
• Reoperation within the first 24 postoperative hours
• Chronic opioid use
• Cognitive impairment