Preoperative coping strategies and distress predict postoperative pain and morphine consumption in women undergoing abdominal gynecologic surgery.
OBJECTIVE
The aim of the present study was to predict postoperative pain and morphine consumption based on preoperative psychosocial factors.


METHODS
One hundred and twenty-two women completed measures of distress and coping 1 week before major abdominal gynecological surgery by laparotomy. Forty-eight hours after surgery, measures of pain and negative affect (NA) were completed, and morphine consumption was recorded from a patient-controlled analgesia pump. Four weeks after surgery, measures of pain and NA were completed.


RESULTS
Multivariate analyses revealed that preoperative self-distraction coping (P=.039) positively predicted postoperative pain levels in the hospital, after accounting for the effects of age, concurrent NA, and morphine consumption. Emotional support (P=.031) and religious-based coping (P=.036) positively predicted morphine consumption in the hospital, after accounting for the effects of age, concurrent NA, and pain levels. Preoperative distress (P<.04 to .008) and behavioral disengagement (P=.034), emotional support (P=.049), and religious-based coping (P=.001) positively predicted pain levels 4 weeks after surgery, after accounting for the effects of age and concurrent NA.


CONCLUSIONS
The results suggest that preoperative psychosocial factors are associated with postoperative pain and morphine consumption.
Cohen
Lorenzo
L
Department of Behavioral Science, The University of Texas, M.D. Anderson Cancer Center, Box 243, 1515 Holcombe Boulevard, Houston, TX 77030, USA. lcohen@mdanderson.org
Fouladi
Rachel T
RT
Katz
Joel
J
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control; D011300:Preoperative Care; D011795:Surveys and Questionnaires
D000701:Analgesics, Opioid; D009020:Morphine