Abstract:

Objective To understand the current situation of early postoperative pain within 24 hours in patients undergoing thoracoscopic lung cancer radical resection and analyze the influencing factors，in order to provide a reference for implementing individualized and precise pain management strategies. Methods A prospective cohort study design was adopted. 210 patients who underwent thoracoscopic lung cancer radical resection in a tertiary grade A hospital in Zhejiang Province from July to August 2025 were selected as the research subjects. General information questionnaires，Numerical Rating Scales，and the Chinese version of the functional activity assessment method were used for investigation. Univariable and logistic regression analysis were used to screen the influencing factors of early postoperative pain after thoracoscopic surgery. Results A total of 201 patients was finally included. The incidence of early postoperative pain was 100%. Among them，the incidence of moderate pain was 49.7% （100/201），and the incidence of severe pain was 0%. The results of functional activity assessment showed that 87.7%（176/201） of the patients had a level Ⅱ degree of activity limitation during pain，11.4%（23/201） had a level Ⅲ degree，and 0.9%（2/201） had a level Ⅳ degree. The postoperative pain degree was significantly weakly positively correlated with functional activity limitation（r=0.252，P<0.001），but it could only explain about 6.4% of the variation in functional activity limitation. The results of logistic regression analysis showed that patients with age <65 years（OR=0.970） and pain existing when leaving the anesthesia recovery room（OR=2.344） had a higher risk of moderate pain（P<0.001）. Compared with thoracoscopic lung wedge resection，patients undergoing lung segment or resection had a significantly lower risk of moderate pain（OR=0.097）. Conclusion The incidence of moderate pain after thoracoscopic lung cancer radical resection is relatively high. It is influenced by age，surgical method，and the presence of pain when leaving the anesthesia recovery room. For patients under 65 years old，undergoing wedge surgery，and having pain when leaving the anesthesia recovery room，pain monitoring should be strengthened and the analgesic strategy should be adjusted in time to promote early postoperative rehabilitation.

Key words: Thoracoscopic Radical Resection of Lung Cancer, Pain, Cross-Sectional Study, Root Cause Analysis, Nursing Care