Pain in the Postoperative Coronary Artery Bypass Graft Patient

Abstract

The purpose of this study was to assess and describe the multidimensional postoperative pain experience of patients (N = 194) undergoing coronary artery bypass graft surgery (CABG) using the McGill Pain Questionnaire. Postoperative pain significantly decreased from postoperative day 2 to postoperative day 3 for all components of the McGill Pain Questionnaire. Sensory words chosen from the McGill Pain Questionnaire on postoperative day 2 included sharp, sore, aching, and tender. Affective words chosen included exhausting on postoperative day 2 and tiring on postoperative days 2 and 3. The evaluative word annoying was chosen for both postoperative days 2 and 3. The present pain intensity (PPJ) rating completed on a scale firm no pain = 0 to excruciating pain = 5, showed a mean intensity rating of 1.08 for postoperative day 2 and 0.67 for postoperative day 3. These findings describing the typical pattern of postoperative pain are clinically significant in the differentiation of "normal" postoperative pain from pain experienced with postoperative complications from CABG surgery.

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References

Bohachick, P. , & Eldridge, R. (1988). Chest pain after surgery. Critical Care Nursing, 8(1), 16-22.

Byrne, M. , Troy, A. , Bradley, L. A. , Marchisello, P. J. , Geisinger, K. F. , Van der Heide, L. H. , & Prieto, E. J. (1982). Cross-validation of the factor structure of the McGill pain questionnaire. Pain, 13, 193-201.

Dauber, A. , Ure, B. , Neugebauer, E. , Schmitz, S. , & Troldl, H. (1993). The incidence of postoperative pain on general surgical wards: Results of different evaluation procedures. Anaesthetist, 42(7), 448-454.

Ferguson, J. A. (1992). Pain following coronary artery bypass grafting: An exploration of contributing factors. Intensive and Critical Care Nursing, 8, 153-162.

Forshee, T. (1986). Track down the what, where, when, and how of chest pain. Nursing, 16(5), 34-42.

Fortin, J. D. , Schwartz-Barcott, D. , & Rossi, S. (1992). The postoperative pain experience: A description based on the McGill pain questionnaire. Clinical Nursing Research, 1(3), 292-304.

Graham, C. , Bond, S. S. , Gerkovich, M. M. , & Cook, M. R. (1980). Use of the McGill pain questionnaire in the assessment of cancer pain: Republicability and consistency. Pain, 8, 377-387.

Heye, M. L. (1991). Pain and discomfort after coronary artery bypass surgery. Cardiovascular Nursing, 27(4), 19-24.

King, K. B. , Norsen, L. H. , Robertson, R. K. , & Hicks, G. L. (1987). Patient management of pain medication after cardiac surgery. Nursing Research, 36(3), 145-255.

10.

Lowe, N. K. , Walker, S. N. , & MacCallum, R. C. (1991). Confirming the theoretical structure of the McGill pain questionnaire in acute clinical pain. Pain, 46, 53-60.

11.

Mailis, A. , Chan, J. , Basinski, A. , Feindel, C. , Vanderlinder, G. , Taylor, A. , Flock, D. , & Evans, D. (1989). Chest wall pain after aortocoronary bypass surgery using internal mammary artery graft: A new pain syndrome? Heart & Lung, 18(6), 553-558.

12.

Melzack, R. (1975). The McGill pain questionnaire: Major properties and scoring methods. Pain, 1, 277-299.

13.

Melzack, R. , & Torgerson, W. S. (1971). On the language of pain. Anesthesiology, 34, 50-59.

14.

Oates, H. B. (1993). Non-pharmacologic pain control for the CABG patient. Dimensions of Critical Care Nursing, 12(6), 296-304.

15.

Prieto, E. J. , Hopson, L. , Bradley, L. A. , Byrne, M. , Geisinger, K. F. , Midox, D. , & Marchisello, P. J. (1980). The language of low back pain: Factor structure of the McGill pain questionnaire. Pain, 8, 11-19.

16.

Puntillo, K. , & Weiss, S. J. (1994). Pain: Its mediators and associated morbidity in critically ill cardiovascular surgical patients. Nursing Research, 43(1), 31-36.

17.

Reading, A. E. (1982). A comparison of the McGill pain questionnaire in chronic and acute pain. Pain, 13, 185-192.

18.

Toomey, T. C. , Gover, V. F. , & Jones, B. N. (1984). Site of pain: Relationship to measures of pain description, behavior and personality. Pain, 19, 389-397.

19.

Wilkie, D. J. , Savedra, M. C. , Holzemer, W. L. , Tesler, M. D. , & Paul, S. M. (1990). Use of the McGill pain questionnaire to measure pain: A meta-analysis. Nursing Research, 39(1), 36-41.