en بیهوشی Anesthesia review review <span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Background:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> Pain following open cardiac surgery is a common and debilitating complication that negatively impacts patients&rsquo; 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</span></span><span style="font-size:12.0pt">.</span></span></span></span></span><br> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><strong>Methods:</strong> 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 2010 to February 2026. 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.</span></span><br> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><strong>Results:</strong> Of the 847 articles identified, 27 studies met the inclusion criteria. Protective factors were classified into five main categories: (1) psychological factors, (2) prehabilitation interventions, (3) factors associated with acute pain management (4) lifestyle factors, and (5) 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.</span></span><br> <strong><span style="font-size:11.0pt"><span style="line-height:107%"><span calibri="" style="font-family:">Conclusion:</span></span></span></strong><span style="font-size:11.0pt"><span style="line-height:107%"><span calibri="" style="font-family:"> 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.</span></span></span> Cardiac surgery, Protective factors, Postoperative pain, Caregiving, Scoping review 0 0 http://rmm.mazums.ac.ir/browse.php?a_code=A-10-1475-1&slc_lang=en&sid=1 Mohammad Forozeshfard mforozeshfard@gmail.com 1 100319475328460013829 No Cancer Research Center and Department of Anesthesiology, Semnan University of Medical Sciences, Semnan, Iran. Shahrzad Izadi Shahrzad.izadi@gmail.com 2 100319475328460013830 No Department of Surgery, Kowsar Hospital, Semnan University of Medical sciences, Semnan, Iran. Kamran Ghods Kamran1230@yahoo.com 3 100319475328460013831 No Department of Cardiac Surgery, Semnan University of Medical Sciences, Semnan, Islamic Republic of Iran. Keshvar Samadaeegelehkolaee k-samadaee@alumnus.tums.ac.ir 4 100319475328460013832 No 4. Sexual and Reproductive Health Research Center, Department of Reproductive Health and Midwifery, Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran. Ilia Zamani Hajiabadi madwx@yahoo.com 5 100319475328460013833 Yes Student research committee, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.