Ying Zhang,1 Fei Zhao,2 Yuanyuan Zhang1 

1Department of Vascular Surgery, Shanxi Provincial People’s Hospital, Taiyuan, 030012, People’s Republic of China; 2Department of Cardiovascular Surgery, Taiyuan Hospital, Peking University First Hospital, Taiyuan, 030009, People’s Republic of China

Correspondence: Yuanyuan Zhang, Department of Vascular Surgery, Shanxi Provincial People’s Hospital, 030012, People’s Republic of China, Email 13994206762@163.com

Objective: To explore effective nursing interventions for severe pain in the early postoperative period following aortic dissection, using a configurational and network perspective.
Methods: Convenience sampling was employed, selecting 116 patients from the Vascular Surgery Department of Shanxi Provincial People’s Hospital between August 2021 and March 2024. Patients who underwent aortic dissection surgery and had a VAS (Visual Analog Scale) pain score of 6 or higher were provided comprehensive nursing interventions for one week, which included analgesics, cold compresses, musicotherapy, mental intervention, posture guidance, and light physical activity. Nursing intervention was treated as the antecedent variable, while changes in VAS scores were considered the outcome variable of analgesic efficacy. Fuzzy-set qualitative comparative analysis (fsQCA) and network analysis were used to identify the most effective analgesic interventions.
Results: No single nursing intervention was found to be a necessary condition for good postoperative analgesia. Five configurations were found to contribute to effective analgesia, with an overall consistency of 0.959 and overall coverage of 0.262. Cold compresses and musicotherapy emerged as important core conditions. Network analysis showed that cold compresses, posture guidance, and musicotherapy had a direct positive effect on pain relief, while analgesics and mental interventions had less apparent effects, and light physical activity could potentially be detrimental to pain relief.
Conclusion: For early postoperative pain following aortic dissection, besides providing analgesics and psychological counseling as needed, cold compresses and musicotherapy should be tailored according to patient preferences to promote analgesic efficacy.

Keywords: aortic dissection, postoperative analgesia, nursing interventions, configurational perspective, network analysis