[Measurement of postoperative pain: analysis of the sensitivity of various self-evaluation instruments].
OBJECTIVE
This study compared the sensitivity of two one-dimensional scales (a visual analog scale [VAS] and a verbal scale of pain intensity [VSPI]) and one multidimensional scale (McGill Pain Questionnaire-Spanish Version [MPQ-SV]) for detecting changes in pain after a variety of surgical procedures with postoperative analgesia provided by one of two methods.


METHODS
Forty-two patients who underwent abdominal surgery, hysterectomy, cesarean, inguinal herniorrhaphy, subcostal or medial laparoscopic cholecystectomy were studied. Postoperative analgesia consisted of 1 mg/Kg of intravenous pethidine every 4 h in group one (n = 20) and intramuscular diclofenac every 12 h in group two. Assessment was at 24 h and/or at 48 and 72 h using the VAS, the VSPI and the MPQ-SV.


RESULTS
All the scales were useful for assessing postoperative pain, giving estimates that were sensitive to variations in pain on days after the operation. The MPQ-SV was able to detect different pain-producing capacities for the surgical procedures more effectively than were the one-dimensional scales. The MPQ-SV was also able to discriminate the qualitative and quantitative differences among the mechanisms of action of opioid and nonsteroidal anti-inflammatory drugs, whereas the one-dimensional scales were unable to distinguish therapeutic approach.


CONCLUSIONS
All the scales were sensitive to changes in postoperative pain, but the MPQ-SV gave more precise information of differences between analgesic treatments and among operations.
Lázaro
C
C
Departamento de Farmacología, de Terapéutica y de Toxicología, Facultad de Medicina, Universitat Autònoma de Barcelona. 20426cla@comb.es
Caseras
X
X
Torrubia
R
R
Baños
J E
JE
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D004008:Diclofenac / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008614:Meperidine / Q000627:therapeutic use; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000523:psychology; D010147:Pain Measurement / Q000379:methods*; D010149:Postoperative Pain / Q000175:diagnosis*; D012647:Self-Assessment; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D013997:Time Factors
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D008614:Meperidine