title: Catastrophizing: a risk factor for postsurgical pain.
abstract: OBJECTIVE
  This research was designed to test the hypothesis that presurgery "catastrophizing" would predict postsurgical pain and postsurgical analgesic consumption.
  
  
  METHODS
  A sample of 48 individuals who underwent anterior cruciate ligament repair participated in the study. All participants completed the Pain Catastrophizing Scale (described by Sullivan et al in 1995) prior to surgery. Measures of pain (pain scores on a scale of 0-10) were obtained in the postanesthetic care unit, as well as 1, 2, and 7 days after surgery. Opioid and nonopioid analgesic consumption was tabulated while patients were in the hospital and after discharge.
  
  
  RESULTS
  Results showed that the Pain Catastrophizing Scale was a significant predictor of acute postsurgical pain in the postanesthetic care unit (r = 0.48, P = 0.004 for maximum pain in the postanesthetic care unit). Maximum pain ratings in patients with high Pain Catastrophizing Scale scores (> median of 13) were 33% to 74% higher numerically than in patients with low Pain Catastrophizing Scale scores (< or = median), and the duration of moderate-severe pain (>3/10) was more prolonged (45 minutes versus 28 minutes in patients with high and low Pain Catastrophizing Scale scores, respectively; P < 0.05). The Pain Catastrophizing Scale was also predictive of pain with activity at 24 hours (r = 0.65 for pain on walking, P < or = 0.0001). The Pain Catastrophizing Scale did not predict postoperative analgesic use.
  
  
  CONCLUSIONS
  The pattern of findings suggests that high catastrophizing scores may be a risk factor for heightened pain following surgery. Clinical and theoretical implications of the findings are addressed.
authors.affiliation: Department of Anesthesiology, University of Washington School of Medicine, Seattle, Washington 98195, USA. jpavlin@u.washington.edu
authors.forename: D Janet
authors.initials: DJ
authors.lastname: Pavlin
authors.forename: Michael J L
authors.initials: MJ
authors.lastname: Sullivan
authors.forename: Peter R
authors.initials: PR
authors.lastname: Freund
authors.forename: Kristine
authors.initials: K
authors.lastname: Roesen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*; D017060:Patient Satisfaction; D011581:Psychological Tests; D012307:Risk Factors
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal