Factors Associated with Postoperative Pain among Patients after Thoracic Surgery in a Tertiary Care Teaching Hospital of Punjab, Pakistan

Authors

Abstract

Objective: To identify factors associated with postoperative pain severity among thoracic surgery patients at a tertiary care hospital in Punjab, Pakistan.

Methods

This cross-sectional study included 284 patients who underwent thoracic surgery between January-September 2025. Pain was assessed using Visual Analog Scale (VAS) at 24, 48, and 72 hours postoperatively. Multiple logistic regression identified independent predictors of severe pain.

Results

 Mean age was 52.3±14.6 years; 64.1% were male. Moderate to severe pain (VAS≥4) affected 68.3% at 24 hours, decreasing to 42.6% at 72 hours. Open thoracotomy (OR=4.23, 95% CI: 2.45-7.31, p<0.001), surgery duration >180 minutes (OR=2.89, p<0.001), current smoking (OR=2.34, p=0.001), and BMI≥30 kg/m² (OR=1.87, p=0.023) independently predicted severe pain. Epidural analgesia reduced severe pain risk by 69% (OR=0.31, p<0.001). Poor pain control was associated with increased respiratory complications (28.3% vs 12.1%, p<0.001) and prolonged hospitalization (8.4±2.3 vs 5.6±1.8 days, p<0.001).

Conclusion

  Open thoracotomy, prolonged surgery, smoking, and obesity independently predict severe postoperative pain. Epidural analgesia and multimodal protocols can significantly improve outcomes in thoracic surgery patients.

Keywords:

Postoperative pain, thoracic surgery, pain management, epidural analgesia, Visual Analog Scale, Pakistan

Published

2026/06/03

Issue

Vol. Volume 7-issue 2

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