Does expecting more pain make it more intense? Factors associated with the first week pain trajectories after breast cancer surgery

Sipilä, Reetta; Haasio, Lassi; Meretoja, Tuomo J.; Ripatti, Samuli; Estlander, Ann-Mari; Kalso, Eija

doi:10.1097/j.pain.0000000000000859

Cited by 63 publications

(51 citation statements)

References 51 publications

(71 reference statements)

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“…Fletcher et al [6] have reported an incidence of moderate to severe CPOP of 11.8% at 1 year after surgery whereas Haroutiunian et al [7] reported the incidence of 6-68% for postoperative neuropathic pain depending on the type of surgery. Several risk factors are associated with the development of CPOP such as preoperative pain, type of surgery, perioperative nerve injury, fear of surgery, pain catastrophizing, anxiety, expectation of pain, obesity, young age and sex (female) [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Genetics and genomics in postoperative pain and analgesia

Palada

Kaunisto

Kalso

2018

Current Opinion in Anaesthesiology

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Section: Introductionmentioning

confidence: 99%

Genetics and genomics in postoperative pain and analgesia

Palada

Kaunisto

Kalso

2018

Current Opinion in Anaesthesiology

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“…In a recent study in 563 women having breast cancer surgery, Sipilä and colleagues [21] found that patient's expectations of severe postoperative pain were associated with higher clinical pain intensity and increased initial oxycodone use at the PACU. In contrast, in another and smaller prospective study [10] investigating patients' ability to forecast their disability and pain two weeks after hand surgery, only weak correlations between forecasted and realized pain was discovered [10].…”

Section: Discussionmentioning

confidence: 99%

Using four different clinical tools as predictors for pain after total hip arthroplasty: a prospective cohort study

et al. 2020

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Background: Treatment of postoperative pain remains a significant clinical problem, and prediction of patients with a risk of higher postoperative pain levels is an important focus. We aimed to identify patients undergoing total hip arthroplasty (THA) with risk of higher pain levels at 24 h postoperatively by using four simple and easily available clinical tools. Methods: This prospective observational cohort study included 102 patients having THA at Zealand University Hospital in Denmark. The following predictive tools were investigated for identifying patients with higher postoperative pain levels at 24 h postoperatively, both at rest and during mobilization: preoperative pain by peripheral venous cannulation (PVC) (dichotomized according to numerical rating scale pain ≤ 2/> 2 (PVC-Low/PVC-High) (primary outcome); the post anesthesia care unit (PACU) nurses' expectations of patients pain levels; patients early pain levels at the PACU; and patients own forecast of postoperative pain levels. The Mann-Whitney U test was used to analyze comparisons between prediction groups. For the primary outcome we considered a p-value < 0.01 as statistically significant and for other outcomes a p-value of 0.05. Results: We found no significant differences between the PVC groups for pain during mobilization at 24-h postoperatively: PVC-Low: 6 (4-8) (median, (IQR)) versus PVC-High: 7 (5-8) (median, (IQR)), p = 0.10; and for pain at rest: PVC-Low 2 (0-3) (median, (IQR)) versus PVC-High 3 (2-5) (median, (IQR)), p = 0.12. Other comparisons performed between predictive groups did not differ significantly. Conclusions: In this prospective cohort study of 102 THA patients, we did not find that preoperative pain by PVC, when using a cutoff point of NRS ≤ 2, were able to predict postoperative pain at 24 h postoperatively. Neither did PACU nurses' prediction of pain, patients forecast of pain, nor did maximum pain levels at the PACU. Trial registration: Retrospectively registered 20th February 2018 at ClinicalTrials.gov (NCT03439566).

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“…Several perioperative factors such as age, catastrophizing pain scores, gender, and psychological distress have been suggested to be closely associated with patient pain perception before operations [9][10][11]. Preoperative expectations of pain may also affect the severity of postoperative pain [12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

The application of preoperative self-anticipating pain scores in predicting surgical pain after elective surgery

Chang¹,

Hsieh²,

Chen³

et al. 2020

Preprint

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Background Current principles of postoperative pain management are primarily based on the types and extent of surgical intervention. This clinical study measured patient’s self-anticipating pain score before operation, and correlated the scores with the actual pain levels and analgesic requirement after operation. Methods This prospective cross-sectional, observational study recruited consecutive patients who received elective surgery in the E-Da Hospital, Taiwan from June to August 2018. Patients were invited to complete a structured questionnaire during preoperative anesthesia assessment that surveyed patient’s self-anticipating pain level (numeric rating scale, NRS 0-10) for the scheduled procedure. The actual pain score (visual analogue scale, VAS) experienced by the patient and the total equivalent dose of opioids administered after operation were recorded. Results A total of 996 patients were recruited and 1 patients were excluded due to incomplete data. Most of the patients (86%) received general anesthesia and 73.9% of them had prior operation history. Patients with younger ages (<40 years) and those took regular benzodiazepine for sleep disorder anticipated significantly higher pain levels. Male patients anticipated significantly lower NRS than females (odd ratio 1.710; 95% CI 1.254-2.331). Patients who scheduled for laparotomy, orthopedic surgery or long procedures had higher anticipating NRS. Although higher anticipating NRS were associated with higher postoperative VAS scores and higher total equivalent opioid dose for acute pain management, these surgical patients actually experienced less VAS than they anticipated at the post-anesthesia care unit. Conclusion This observational study found that female, younger age (<40 years), regular benzodiazepine user and patients who scheduled for long procedure (>2 h), laparotomy or orthopedic surgery are anticipating significantly higher surgical-related pain. Therefore, appropriate preoperative counseling for analgesic control and elimination of unnecessary anticipating pain levels in these patients would be necessary to improve the quality of anesthesia service and patient’s satisfaction.

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Does expecting more pain make it more intense? Factors associated with the first week pain trajectories after breast cancer surgery

Abstract: We studied postoperative pain trajectories and associated factors. Expectation of severe postoperative pain was associated with higher intensity of experimental and postoperative pain.

Cited by 63 publications

References 51 publications

Genetics and genomics in postoperative pain and analgesia

Genetics and genomics in postoperative pain and analgesia

Using four different clinical tools as predictors for pain after total hip arthroplasty: a prospective cohort study

The application of preoperative self-anticipating pain scores in predicting surgical pain after elective surgery

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