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Prediction of post-operative pain after a laparoscopic tubal ligation procedure.

AbstractBACKGROUND:
Pre-operative identification of reliable predictors of post-operative pain may lead to improved pain management strategies. We investigated the correlation between pre-operative pain, psychometric variables, response to heat stimuli and post-operative pain following a laparoscopic tubal ligation procedure.
METHODS:
Assessments of anxiety, mood, psychological vulnerability and pre-operative pain were made before surgery using the State-Trait Anxiety Inventory (STAI), the Hospital Anxiety Depression Scale (HADS), a psychological vulnerability test and the Short-Form McGill Pain Questionnaire (SF-MPQ), respectively. Pre-operative assessments of thermal thresholds and pain response to randomized series of heat stimuli (1 s, 44-48 degrees C) were made with quantitative sensory testing technique. Post-operative pain intensity was evaluated daily by a visual analogue scale during rest and during standardized dynamic conditions for 10 days following surgery. Univariate and multivariate regression analyses were used to construct prediction models.
RESULTS:
Fifty-nine patients completed the study. Post-operative pain was significantly correlated with pre-operative pain (SF-MPQ), heat pain perception, psychological vulnerability, STAI and HADS. In the multiple regression model pre-operative pain and heat pain perception were significant predictive factors (R=0.537-0.609).
CONCLUSION:
The study indicates that pre-surgical pain and heat pain sensitivity are important pre-operative indicators of post-operative pain intensity, while psychological factors like vulnerability and anxiety seem to contribute to a lesser degree after laparoscopic tubal ligation. The prediction model accounted for 29-43% of the total variance in post-operative movement-related pain.
AuthorsA Rudin, P Wölner-Hanssen, M Hellbom, M U Werner
JournalActa anaesthesiologica Scandinavica (Acta Anaesthesiol Scand) Vol. 52 Issue 7 Pg. 938-45 (Aug 2008) ISSN: 1399-6576 [Electronic] England
PMID18477083 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Adult
  • Anxiety (diagnosis, psychology)
  • Depression (diagnosis, psychology)
  • Female
  • Hot Temperature (adverse effects)
  • Humans
  • Laparoscopy (adverse effects, methods, psychology)
  • Pain Measurement (methods, psychology, statistics & numerical data)
  • Pain, Postoperative (drug therapy, prevention & control, psychology)
  • Physical Stimulation (adverse effects, methods)
  • Predictive Value of Tests
  • Psychiatric Status Rating Scales
  • Psychometrics (methods, statistics & numerical data)
  • Severity of Illness Index
  • Sterilization, Tubal (adverse effects, methods, psychology)

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