[Comparison of the severity of postoperative pain in patients after thoracic, upper abdominal or lower abdominal surgery].

Different factors influence the severity of postoperative pain. Personality and cultural factors as well as anxiety and fear modify the degree of postoperative pain. The site of surgery is also a major determinant. We evaluated the severity of postoperative pain in patients after three different surgeries, thoracic, upper abdominal and lower abdominal surgeries, from 24 h to 72 h postoperatively. Thirty patients were divided into three groups: thoracic, upper abdominal and lower abdominal groups (n = 10, respectively). All patients received continuous epidural infusion of 0.25% bupivacaine (2 ml.h-1) and buprenorphine (0.2 mg x 24 h-1). Additional analgesics were given when the patient complained of pain. Analgesia was evaluated by 100 mm visual analog scale and demands of analgesics. Pain scores at rest were not different among three groups. Pain after lower abdominal surgery tended to be less severe compared with that after thoracic surgery. Demands of analgesics were not different among three groups at any evaluated point. Pain after thoracic surgery was consistent during 72 postoperative hs, but in the upper and lower abdominal surgery groups pain at 72 hs was significantly weaker than that at 24 hs. We conclude that postoperative pain was not different among the three surgery groups, but pain after upper and lower abdominal surgery decreased more rapidly compared with that after thoracic surgery.