Table1_Psychological states could affect postsurgical pain after hemorrhoidectomy: A prospective cohort study.docx

BackgroundOpen hemorrhoidectomy is one of the standard procedures for grade IV hemorrhoids. Postsurgical pain is a common problem for patients. We aim to prospectively evaluate potential factors affecting postoperative pain among hemorrhoidectomy patients.MethodsAn observational study was conducted on 360 patients who had undergone Milligan-Morgan open hemorrhoidectomy. Details of the surgery and baseline information were recorded. Preoperative anxiety and depression were analyzed via the self-rating anxiety scale 20 (SAS-20) and self-rating depression scales 20 (SDS-20), respectively. Postoperative pain score was performed daily after surgery until the patient was discharged. The numerical pain score was evaluated by the visual analogue scale (VAS). The association between preoperative psychological states (anxiety or depression) and postoperative pain was analyzed using a generalized additive mixed model.ResultsA total of 340 patients eventually provided complete data and were included in our study. The average age was 43.3 ± 14.4 years, and 62.1% of patients were women. In total, 14.9% of patients had presurgical anxiety and 47.1% had presurgical depression. Postsurgical pain reached a peak point 1–2 days after surgery and went down to a very low level around 4–5 days after surgery. More excision of hemorrhoids could lead to more pain experience after surgery. Presurgical depression was associated with postsurgical pain. Patients who had presurgical depression had higher pain scores after surgery (2.3 ± 1.9 vs. 3.3 ± 1.9, p = 0.025).ConclusionPreoperative depression and the amount of excisional hemorrhoids are positively related to postsurgical pain.

背景：开放性背景痔切除术是治疗四级痔的常规手术方法之一。术后疼痛是患者常见的并发症。本研究旨在前瞻性地评估影响痔切除术患者术后疼痛的潜在因素。方法：对360名接受Milligan-Morgan开放性痔切除术的患者进行了观察性研究。记录了手术细节和基线信息。通过自我评定焦虑量表20（SAS-20）和自我评定抑郁量表20（SDS-20）分别分析了术前焦虑和抑郁情况。术后疼痛评分在术后每日进行，直至患者出院。疼痛评分通过视觉模拟评分法（VAS）进行评估。使用广义加性混合模型分析了术前心理状态（焦虑或抑郁）与术后疼痛之间的关系。结果：共有340名患者提供了完整数据并纳入本研究。平均年龄为43.3±14.4岁，其中62.1%为女性。总共有14.9%的患者术前存在焦虑，47.1%的患者术前存在抑郁。术后疼痛在术后1-2天内达到峰值，在术后4-5天内降至非常低的水平。痔切除术的切除量越大，术后疼痛体验越强烈。术前抑郁与术后疼痛相关。有术前抑郁的患者术后疼痛评分更高（2.3±1.9 vs. 3.3±1.9，p=0.025）。结论：术前抑郁和切除痔的量与术后疼痛呈正相关。