Breath-holding Test in the Prognosis of Postoperative Pain in Laparoscopic Gynecology: Observational Cohort Study

Dmitriev, Alexey; Trembach, Nikita

Breath-holding Test in the Prognosis of Postoperative Pain in Laparoscopic Gynecology: Observational Cohort Study

Alexey Dmitriev¹^iD, Nikita Trembach^{1, *}^iD

¹ Department of Anesthesiology, Kuban State Medical University, Krasnodar 350000, Russian Federation

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Identifiers and Pagination:

Year: 2024
Volume: 18
E-location ID: e25896458296522
Publisher ID: e25896458296522
DOI: 10.2174/0125896458296522240404043901

Article History:

Received Date: 30/01/2024
Revision Received Date: 06/03/2024
Acceptance Date: 19/03/2024
Electronic publication date: 06/05/2024
Collection year: 2024

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© 2024 The Author(s). Published by Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

^* Address correspondence to this author at the Department of Anesthesiology, Kuban State Medical University, Krasnodar 350000, Russian Federation, Sedin Street, 4, Tel: +79528589299; E-mail: trembachnv@mail.ru

Background

The problem of perioperative pain relief has not lost its relevance over the years. Studies have shown that patients report moderate to severe pain after surgery, even after laparoscopy. In recent years, specialists have focused on the role of baroreflex sensitivity in the functional state of the nociceptive and antinociceptive systems. Studies have shown that a test with maximum breath-holding during inspiration allows for a non-invasive and accurate assessment of the functional state of the cardiorespiratory system, making it possible to identify a cohort of patients with reduced baroreflex sensitivity

Objective

The aim of the study was to assess the relationship between the breath-holding test and postoperative pain and to develop a model for predicting pain after laparoscopic gynecological surgery.

Methods

Data from 489 patients undergoing gynecological laparoscopy at the Clinic of the Kuban State Medical University from August 2019 to September 2023 were analyzed.

Results

Severe postoperative pain was reported in 146 patients (29.9%). The duration of breath-holding was statistically significantly correlated with NRS upon admission to the PACU at all time points of the study (from -0,15 to -0,21). Logistic regression showed that the Generalized Anxiety Disorder scale score, Pain Catastrophizing Scale score, duration of surgery, Breath-holding duration, and endometriosis surgery influenced the risk of severe postoperative pain (NRS 7-10) (AUROC 0,809).

Conclusion

The breath-holding test, along with other factors, may be useful in assessing the risk of severe postoperative pain after laparoscopic gynecology.

Keywords: Laparoscopic gynecology, Pain, Baroreflex, Breath-holding, Perioperative pain, Surgery.

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RESEARCH ARTICLE

Breath-holding Test in the Prognosis of Postoperative Pain in Laparoscopic Gynecology: Observational Cohort Study

Article Information

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Abstract

Background

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Conclusion

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