Anxiety and Depression Affect Early Postoperative Pain Dimensions after Bariatric Surgery

Abstract

Uncontrolled postoperative pain and prolonged immobilization after bariatric surgery have been associated with increased postoperative complications and prolonged hospitalization. The aim of our study was to evaluate the postoperative pain that follows bariatric surgery and identify any psychological factors that may affect the early postoperative perception of pain. The study included 100 patients with obesity (women, n = 61; age 37.4 ± 9.9 years, mean ± standard deviation; Body Mass Index (BMI) 47.6 ± 6.5 kg/m2) who underwent bariatric surgery. Preoperative anxiety and depression were evaluated by the Hospital Anxiety and Depression Scale (HADS), and the quantitative and qualitative dimension of early postoperative pain were evaluated by the McGill Pain Questionnaire Short Form (MPQ-SF). Furthermore, the postoperative analgesia protocol was recorded for each patient. Pain declined gradually during the first 24 h postoperative. Although preoperative anxiety had no correlation with the overall pain of postoperative Day 0, patients with a higher level of preoperative anxiety had significantly more intense and more unpleasant pain at 1 h post operation. In addition, depression influences both the intensity and unpleasantness of pain at different time points (1 h, 4 h and 24 h postoperative). Preoperative pain correlated with educational level, but not with age, BMI, gender, marital status, smoking and surgery type. In conclusion, preoperative anxiety and depression influence the early postoperative pain after bariatric surgery, and their preoperative identification is of major importance to enhance the implementation of fast-track postoperative protocols to prevent complications and prolonged hospitalization.

The Effects of Preoperative Anxiety Level in Patients with Nasogastric Tube Inserted on Postoperative Quality of Recovery and Pain undergoing Laparoscopic Cholecystectomy under General Anesthesia

“…Studies have highlighted that preoperative anxiety increases the amount of anesthetic drugs, reduces heart rate variability and affects intraoperative blood pressure, and prolongs emergence time. Preoperative anxiety could also aggravate postoperative pain intensity and increase the demand for postoperative analgesic drugs [8][9][10]25] . There is still lack of research about the effects of preoperative anxiety on the postoperative quality of recovery.…”

“…Although preoperative anxiety does not belong to the category of psychiatric disorders, it could increase the dosage of anesthetic drugs, exacerbate postoperative pain, raise the demand for postoperative analgesic drugs, and affect the patient's postoperative recovery [8][9][10][11] .…”

Preoperative Anxiety and Postoperative Pain in Patients With Laparoscopic Hysterectomy

“…The returned incomplete questionnaire forms were timely supplemented on site. One day after the operation, the pain was assessed with the NRS (Suffeda et al, 2016;Gravani et al, 2020;Shen et al, 2020) when the patient was awake.…”

“…A report points out that postoperative pain is not adequately managed in greater than 80% of patients in the United States (Gan, 2017). If pain cannot be fully controlled, acute postoperative pain is harmful and may cause great distress to patients (Schug, 2011;Gravani et al, 2020;Shen et al, 2020).…”

“…The degree of postoperative pain was greatly affected by the degree of anxiety, and the increase of postoperative pain stimulated the anxiety reaction again, forming a cycle of pain and anxiety. Pain can lead to anxiety, and anxiety can enhance pain (Spivey et al, 2018;Gravani et al, 2020;Hah et al, 2020).…”