What are the Protective Factors to Reduce the Incidence and Severity of Pain After Open Heart Surgery? : A Scoping Review

Background: Pain following open cardiac surgery is a common and debilitating complication that negatively impacts patients’ quality of life. Although extensive research has focused on risk factors, protective factors that may reduce the incidence or severity of pain have received less attention. The aim of this scoping review was to identify and categorize protective factors against pain after open cardiac surgery and to elucidate their mechanisms of action. Methods: This scoping review was conducted in accordance with the PRISMA-ScR guidelines. A systematic search was performed in PubMed, Scopus, Web of Science, and Cochrane Library for studies published from ۲۰۱۰ to February ۲۰۲۶. Studies investigating factors associated with reduced incidence or severity of pain following open heart surgery were included. Data extraction was carried out independently by two authors, and the identified factors were reported. Results: Of the ۸۴۷ articles identified, ۲۷ studies met the inclusion criteria. Protective factors were classified into five main categories: (۱) psychological factors, (۲) prehabilitation interventions, (۳) factors associated with acute pain management (۴) lifestyle factors, and (۵) social support. The underlying mechanisms of action included modulation of inflammation, reduction of central sensitization, enhancement of descending inhibitory pain pathways, and improvement in coping strategies. Conclusion: This study offers a new perspective on post-cardiac surgery pain management, emphasizing protective factors and novel biotechnological approaches. Integrated multimodal interventions may reduce suffering, prevent chronic pain, and improve quality of life. Future trials should validate biotechnological strategies and explore underlying bio-psychosocial and molecular mechanisms.

کلیدواژه ها:

Cardiac surgery ، Protective factors ، Postoperative pain ، Caregiving ، Scoping review