JNCR
Journal of Nursing Care Research

The mission of the journal is to contribute to the development of nursing science and care practices in Turkey and internationally. It is also to promote and disseminate new knowledge and research data for evidence-based care practices at all levels of nursing services. The Journal of Nursing Care Research deals with Fundamentals of Nursing, Internal Medicine Nursing, Surgical Nursing, Obstetrics and Gynecology Nursing, Child Health and Diseases Nursing, Mental Health and Diseases Nursing, Public Health Nursing and Management in Nursing and accepts articles on these topics.

eISSN: 3023-7270
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Original Article
Evaluating the postoperative pain of video-assisted thoracoscopic sympathectomypatients by four pain scales
Abstract
Aims: Evaluation of postoperative pain level in patients who underwent video-assisted thoracoscopic sympathectomy is important in establishing pain protocols. The aim was to investigate the pain assessment scale that best reflects, most accurately, and effectively describes the patients' pain levels.
Methods: This single-center study was conducted with an observational-descriptive design. The study was completed with 41 patients in the thoracic surgery clinic of a training and research hospital in the fall of 2019 and spring of 2020. The questionnaire form included questions about the descriptive and pain characteristics of the participants. Pain levels were questioned using 4 pain scales (These scales were Numeric Rating Scale [NRS, Visual Analog Scale (VAS), Faces Pain Scale revised (FPS-R), and Color Analog Scale (CAS)]. before and approximately 1-2 hours after the administration of postoperative painkillers. The scale that best reflected their pain was questioned.
Results: Before the administration of analgesics, the pain characteristics were assessed when patients reported experiencing postoperative pain. Accordingly, most of the participants (36.6%, n=15) stated that they had "back pain at the incision line of the anterior chest wall", 19.5% had pain in the upper anterior aspect of the chest, and 9.8% had anterior chest pain. He stated that 34.1% had pain spreading to other regions, and 6 patients had pain radiating to the back. 39% (n=16) reported stinging pain, 19.5% (n=8) tingling, and 17.1% (n=7) sharp pain. A very strong and significant positive correlation was found between NRS and VAS in four scale correlations with pre-analgesic pain level. It turned out that the best tool was the NRS.
Conclusion: Comparison of four pain scale scores before and after analgesia in this patient group showed that the highest mean score was obtained from NRS, followed by VAS, CAS and FPS-R, respectively.

Keywords : Sympathectomy, pain, postoperative, thoracic, nursing

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Arslan, S., & Celebioglu, A. (2004). Postoperative pain management and alternative applications. Int J Human Sci, 1(1), 1-7.
Aziato, L., Dedey, F., Marfo, K., Asamani, J. A., & Clegg-Lamptey, J. N. (2015). Validation of Three Pain Scales among adult postoperative patients in Ghana. BMC Nursing, 14, 42. doi:10.1186/s12912-015-0094-6
Bas, N. S., & Ayhan, H. (2024). Comparison of Four Different Pain Scales and patient preferences in the evaluation of pain severity after open cardiac surgery. Int J Caring Sci, 17(2), 921-932.
Bolotin, G., Lazarovici, H., Uretzky, G., Zlotnick, A. Y., Tamir, A., & Saute, M. (2000). The efficacy of intraoperative internal intercostal nerve block during video-assisted thoracic surgery on postoperative pain. Ann Thorac Surg, 70(6), 1872-1875. doi:10.1016/S0003-4975(00)01757-4
Bulloch, B., Garcia-Filion, P., Notricia, D., Bryson, M., & McConahay, T. (2009). Reliability of the CAS color analog scale: Reproducibility of scores in traumatic and nontraumatic injuries. Acad Emerg Med, 16(5), 465-469. doi:10.1111/j.1553-2712.2009.00404.x
Campos, J. R. M., Kauffman, P., Gomes, O. Jr., & Wolosker, N. (2016). Video-assisted thoracic sympathectomy for hyperhidrosis: review. Thorac Surg Clin, 26(3), 347-358. doi:10.1016/j.thorsurg.2016.04.010
Chou, R., Gordon, D. B., de Leon-Casasola, O. A., Rosenberg, J. M., Bickler, S., Brennan, T., … & Wu, C. L. (2016). Management of postoperative pain: a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists. J Pain, 17(2), 131-157. doi:10.1016/j.jpain.2015.12.008
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum.
Cok, O. Y., Eker, H. E., Fındıkcıoglu, A., Akın, Ş., Arıbogan, A., & Arslan, G. (2011). Clinical research, perioperative management in sympathectomy with video-assisted thoracoscopic surgery: retrospective clinical research. J Turk Soc Anesthesiol Reanimat, 39(5), 232-240. doi:10.1016/j.ejcts.2009.07.040
Dias, M. D. L., Burlamaque, A. A., Bagatini, A., Ribas, F. A., & Gomes, C. R. (2005). Simpatectomia por videotoracoscopia no tratamento da hyperhidrosis palmar: implicações anestésicas. Revista Brasil Anestesiol, 55(3), 361-368.
Duzel, V. (2008). Comparison of postoperative pain assessments of nurses and patients [Master’s thesis, Cukurova University Institute of Health Sciences, Department of Nursing].
Fiorelli, A., Vicidomini, G., Laperuta, P., Busiello, L., Perrone, A., Napolitano, F., ... & Santini, M. (2010). Preemptive local analgesia in video-assisted thoracic surgery sympathectomy. Eur J Cardio Thorac Surg, 37(3), 588-593. doi:10.1016/j.ejcts.2009.07.040
George, D., & Mallery, M. (2010). SPSS for Windows step by step: a simple guide and reference, 17.0 update (10th ed.). Pearson.
Gurkan, A., Aldemir, K., Andsoy, I. I., & Gul, A. (2020). Comparison of Four Different Pain Scales in the evaluation of postoperative acute pain intensity. Cukurova Med J, 45(4), 1562-1571. doi:10.17826/cumj.741465
Jensen, M. P. (2010). Measurement of pain. In S. M. Fishman, J. C. Ballantyne, & J. P. Rathmell (Eds.), Bonica’s management of pain (pp. 251-270). Williams & Wilkins.
Kalaycı, Ş. (Ed.). (2006). SPSS applied multivariate statistical techniques. Asil Publishing Distribution.
Karahan, A., Yıldırım, F., Abbasoglu, A., Akkuzu, G., & Akyüz, N. (2012). Comparison of Three Rating Scales for assessing pain intensity in an intensive care unit. Turk J Thorac Cardiovas Surg, 20(1), 39-44. doi:10.5606/tgkdc.dergisi.2012.008
Kong, M., Li, X., Shen, J., Ye, M., Xiang, H., & Ma, D. (2020). The effectiveness of preemptive analgesia for relieving postoperative pain after video-assisted thoracoscopic surgery (VATS): a prospective, nonrandomized controlled trial. J Thorac Dis, 12(9), 4930-4940. doi:10.21037/jtd-20-2500
Li, L., Liu, X., & Herr, K. (2007). Postoperative pain intensity assessment: a comparison of four scales in Chinese adults. Pain Medicine, 8(3), 223-234. doi:10.1111/j.1526-4637.2007.00296.x
Mandysová, P., & Kadlecková, Z. (2015). The performance of three pain intensity scales and their preferences among Czech women with acute postoperative pain. Centr Eur J Nurs Midwifery, 6(2), 298-305. doi:10.15452/CEJNM.2015.06.0019
Mark, J., Paul, K., & Sanford, B. (1986). The measurement of clinical pain intensity: a comparison of six methods. Pain, 27(1), 117-126. doi:10.1016/0304-3959(86)90228-9
Raposio, E., & Caruana, G. (2015). Video-assisted thoracic sympathicotomy for the treatment of palmar and axillary hyperhidrosis:a 17-year experience. Surgical Laparos Endos Percut Techniq, 25(5), 417-419. doi:10.1097/SLE.0000000000000126
Stefaniak, T. J., & Cwigon, M. (2013). Long-term results of thoracic sympathectomy for primary hyperhidrosis. Polski Przeglad Chirurgiczny, 85(5), 247-252. doi:10.2478/pjs-2013-0038
Svensson, I., Sjöström, B., & Haljamäe, H. (2000). Assessment of pain experiences after elective surgery. J Pain Symp Manag, 20(3), 193-201. doi:10.1016/S0885-3924(00)00174-3
Tabachnick, B. G., & Fidell, L. S. (2013). Using multivariate statistics (6th ed.). Pearson.
Temiz, Z., & Özer, N. (2015). Comparison of postoperative pain severity using four different pain scales. Anat J Nurs Health Sci, 18, 4. doi:10.17049/ahsbd.64890
Tsze, D. S., von Baeyer, C. L., Bulloch, B., & Dayan, P. S. (2013). Validation of Self-Report Pain Scales in children. Pediatrics, 132(4), e971-e979. doi:10.1542/peds.2013-1509
van Dijk, J. F., van Wijck, A. J., Kappen, T. H., Peelen, L. M., Kalkman, C. J., & Schuurmans, M. J. (2012). Postoperative pain assessment based on numeric ratings is not the same for patients and professionals:a cross-sectional study. Int J Nurs Stud, 49(1), 65-71. doi:10.1016/j.ijnurstu.2011.07.005
Vannucci, F., & Araújo, J. A. (2017). Thoracic sympathectomy for hyperhidrosis: from surgical indications to clinical results. J Thorac Dis, 9(Suppl 3), S178-S192. doi:10.21037/jtd.2017.s3-ijh
VATS sympathectomy for hyperhidrosis. (2023, April 30). Multimedia manual of cardio-thoracic surgery. https://mmcts.org/tutorial/1603
Yesilyurt, M., & Faydalı, S. (2020). The use of one-dimensional scales in pain assessment: a review. Anat J Nurs Health Sci, 23(3), 444-451. doi:10.17049/ataunihem.508877
Yurtseven, S., Dogan, S. D., Arslan, S., Nazik, E., & Yuksekkaya, S. E. (2021). Assessment of postoperative pain intensity using Different Pain Scales. Turk Clin J Nurs Sci, 13(1), 1-7.
Zhou, Y., Petpichetchian, W., & Kitrungrote, L. (2011). Psychometric properties of pain intensity scales comparing among postoperative adult patients, elderly patients without and with mild cognitive impairment in China. Int J Nurs Stud, 48(4), 449-457. doi:10.1016/j.ijnurstu.2010.07.017
Article available in :
Volume 2, Issue 3, 2025
Page : 69-75
https://doi.org/10.51271/JNCR-0032
Article Information
Received : 09 Haz 2025
Accepted : 04 Eyl 2025
Published : 19 Eyl 2025
Corresponding Author :

Öznur Kavaklı: Gülhane Faculty of Nursing, University of Health Sciences, Ankara, Turkiye

[email protected]
Citation : Kavaklı, Ö., Özdemir, E., & Şentürk, D. (2025). Evaluating the postoperative pain of video-assisted thoracoscopic sympathectomy patients by Four Pain Scales. J Nurs Care Res, 2(3), 69-75.

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