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


CONCLUSIONS
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.
Rudin
A
A
Department of Anaesthesiology and Intensive Care, University Hospital, Lund, Sweden. asa.rudin@skane.se
Wölner-Hanssen
P
P
Hellbom
M
M
Werner
M U
MU
D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods / Q000523:psychology; D010147:Pain Measurement / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control* / Q000523:psychology; D010812:Physical Stimulation / Q000009:adverse effects / Q000379:methods; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics / Q000379:methods / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013246:Sterilization, Tubal / Q000009:adverse effects* / Q000379:methods / Q000523:psychology