Postoperative pain is one of the main factors associated with the increase of postoperative complications. Pain control may therefore accelerate recovery and increase quality of life (QoL). The aim of this study was to evaluate the incidence of pain after surgery at 3 months of follow up, its impact in the patients QoL and possible risk factors.

After study approval by the Institution Ethics Committee, an observational prospective study was conducted. Patients aged >60 years, submitted to elective surgery, admitted in the Post Anesthetic Care Unit, from May to July 2017 were included. Pre-operatively (T0) was recorded the Quality of Recovery 15 item score (QoR), the Health-related Quality of Life (EQ-5D-5L), the World Health Organization Disability Assessment Schedule 2.0 (WHODAS), the Lawton Instrumental Activities of Daily Living (IADL) Scale. These scores were then repeated 3 months (T1) after surgery. We studied the group of patients having more problems (PMP) with pain at T1 compared to T0 recorded at the EQ-5D-5L. The Chi-square, Fischer´s exact or Mann-Whitney U tests were used for comparisons.

A total of 226 patients were included. The incidence of PMP was 21%. Regarding the patient medical condition, the diagnosis of metastatic neoplasm (p=0.01), and pulmonary disease other than asthma or chronic obstructive pulmonary disease (p=0.02) were more frequent in the PMP. Concerning the perioperative data, hypothermia and the use of antiemetic drugs intraoperatively were less frequent in the PMP (p=0.042 and p=0.024 respectively). PMP had higher WHODAS score (p<0.001), more dependency in IADL (p=0.02), and more problems at every dimensions of EQ-5D-5L at T1 (p<0.001). There were no differences in gender, age, ASA physical status, Body Mass Index, type and length of anesthesia, length of hospital stay.

In this study the PMP had a poor QoL 3 months after surgery. The clinical conditions associated with worse pain control, were metastatic neoplasm and pulmonary disease. Postoperative inadvertent hypothermia and the use of antiemetic drugs given intraoperatively appears to be a protector factor for the increase of pain 3 months after surgery.

06 / Incidence of pain at 3 month follow up in elderly surgical patients