Objective To investigate the occurrence of pain in patients at different stages after cardiac valve replacement, and explore the influencing factors of pain in different stages after surgery, so as to provide reference evidence for the clinical development of more accurate and individual pain management programs. Methods A total of 160 patients who underwent artificial heart valve replacement in the Department of Cardiovascular Surgery of Suining Central Hospital from January 2020 to July 2021 were selected, and the patients’ perioperative data were collected in a systematic manner. The State Anxiety Inventory (SAI) was used to investigate the degree of anxiety 1 day before surgery. Numerical Rating Scale (NRS) and Brief Pain Inventory (BPI) was used to evaluate the incidence of postoperative pain. The subjects were divided into two groups according to whether pain occurred, to explore the influencing factors of pain at different time points after surgery. Results The incidence of pain at different time points after cardiac valve replacement showed a statistically significant difference(P＜0.001), and the overall trend was downward. Univariate analysis of 1 month after surgery showed that age, diabetes, anxiety level 1 day before surgery, amount of remifentanil used during surgery, sternal fixation materials and acute pain 3 days after surgery were the correlation factors of postoperative pain(P＜0.05). Multivariate logistic regression analysis showed that age, anxiety level 1 day before surgery and sternal fixation materials were independent influencing factors of postoperative pain(P＜0.05). Age, anxiety level 1 day before surgery, amount of remifentanil used during surgery, CPB time, and acute pain 3 days after surgery were found to be correlation factors of postoperative 3 months pain(P＜0.05). Multivariate logistic regression analysis showed that age, the amount of remifentanil used during operation, and acute pain 3 days after operation were independent influencing factors of postoperative pain(P＜0.05). At 6 months after surgery univariate analysis showed that age, anxiety level 1 day before surgery, amount of remifentanil used during surgery and acute pain 3 days after surgery were the correlation factors of postoperative pain(P＜0.05). Multivariate logistic regression analysis showed that the anxiety level 1 day before surgery, the amount of remifentanil used during surgery, and acute pain 3 days after surgery were independent influencing factors of postoperative pain(P＜0.05). Conclusion Most of the patients had different degrees of pain at each time point after heart valve replacement, with the progress of patients' rehabilitation,the overall incidence of pain at different time points after heart valve replacement showed a trend of gradual decrease. The independent influencing factors of pain at different time points after cardiac valve replacement are age, anxiety level 1 day before surgery, amount of remifentanil used during surgery, sternal fixation materials and acute pain 3 days after surgery