Preoperative Vitamin D Level is Associated with Acute Pain After Video-Assisted Thoracoscopic Surgery: A Retrospective Cohort Study

• Published in: Journal of pain research Vol. 15; pp. 3189 - 3196
• Main Authors: Zeng, Xiaoping, Chen, Xue, Li, Caixia, Shi, Hong
• Format: Journal Article
• Language: English
• Published: Macclesfield Dove Medical Press Limited 31.10.2022; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Age; Alfacalcidol; Analysis; Body mass index; C-reactive protein; Calcifediol; Chronic pain; Cohort analysis; Drug dosages; Gastrointestinal surgery; Hospitals; inflammatory response; Interleukins; Lymphatic system; Medical personnel; Medical research; Medicine, Experimental; moderate-severe pain; Narcotics; Original Research; Ostomy; Patients; Postoperative period; Sufentanil; Thoracic surgery; Tumor necrosis factor-TNF; Values; Variables; video-assisted thoracoscopic surgery; Vitamin D; Vitamin deficiency; China
• ISSN: 1178-7090; 1178-7090
• DOI: 10.2147/JPR.S382407

Purpose: Low vitamin D levels have been associated with musculoskeletal pain, cancer pain, chronic postoperative pain, and posttraumatic pain. However, their association with postoperative pain after video-assisted thoracoscopic surgery has not been explored. The aim of this study was to examine the association between vitamin D levels and postoperative pain after video-assisted thoracoscopic surgery. Patients and Methods: This study enrolled 194 adult patients who underwent elective non-cardiac thoracic surgery in Shanghai Pulmonary Hospital from February 2021 to June 2021. Following application of the exclusion criteria, 135 patients who underwent video-assisted thoracoscopic surgery were included in the final analysis. The primary outcome was the incidence of acute postoperative moderate-severe pain. Secondary outcomes included C-reactive protein (CRP), interleukin (IL)-1, IL-6, and tumor necrosis factor-[alpha] levels in the immediate postoperative (48 hours) period, as well as pain scores at 3 months after surgery. A multivariable logistic regression model was used to analyze the association between vitamin D levels and acute postoperative moderate-severe pain. Results: Among 135 patients, 54.1% were categorized as having a low vitamin D level (<30 nmol/L). On multivariable analysis, patients with a low 25-hydroxy-vitamin D (25[OH]D) level had a higher risk of postoperative moderate-severe pain (odds ratio, 2.44; 95% confidence interval, 1.181-5.041; P = 0.016) when compared to patients with a sufficient 25(OH)D level. Static and dynamic pain scores at 3 months after surgery, as well as serum levels of CRP, IL-1, IL-6, and tumor necrosis factor-[alpha] were not significantly different between patients with low and sufficient 25(OH)D levels. Conclusion: Patients with low vitamin D levels are at a higher risk of acute moderate-severe pain after video-assisted thoracoscopic surgery. Trial Registration: Keywords: vitamin D, video-assisted thoracoscopic surgery, moderate-severe pain, chronic pain, inflammatory response