title: Postoperative pain associated with orthopedic shoulder and elbow surgery: a prospective study.
abstract: BACKGROUND
  In the last 2 decades, extensive research in postoperative pain management has been undertaken to decrease morbidity. Orthopedic procedures tend to have increased pain compared with other procedures, but further research must be done to manage pain more efficiently. Postoperative pain morbidities and analgesic dependence continue to adversely affect health care.
  
  
  METHODS
  The study assessed the pain of 78 elbow and shoulder surgery patients preoperatively and postoperatively using the Short-Form McGill Pain Questionnaire (SF-MPQ). Preoperatively, each patient scored their preoperative pain (PP) and anticipated postoperative pain (APP). Postoperatively, they scored their 3-day (3dpp) and 6-week postoperative pain (6wpp). The pain intensities at these 4 intervals were then compared and analyzed using Pearson coefficients.
  
  
  RESULTS
  APP and PP were strong predictors of postoperative pain. The average APP was higher than the average postoperative pain. The 6wpp was significantly lower than the 3dpp. Sex, chronicity, and type of surgery were not significant factors; however, the group aged 18 to 39 years had a significant correlation with postoperative pain.
  
  
  CONCLUSIONS
  PP and APP were both independent predictors of increased postoperative pain. PP was also predictive of APP. Although, overall postoperative pain was lower than APP or PP due to pain management techniques, postoperative pain was still significantly higher in patients with increased APP or PP than their counterparts. Therefore, surgeons should factor patient's APP and PP to better manage their patient's postoperative pain to decrease comorbidities.
authors.affiliation: Department of Orthopedic Surgery, Stanford University Medical Center, Redwood City, CA 94063, USA.
authors.forename: Vimal N
authors.initials: VN
authors.lastname: Desai
authors.forename: Emilie V
authors.initials: EV
authors.lastname: Cheung
mesh_terms: D000328:Adult; D015897:Comorbidity; D004550:Elbow / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures; D010149:Postoperative Pain / Q000453:epidemiology*; D011446:Prospective Studies; D012782:Shoulder / Q000601:surgery*; D011795:Surveys and Questionnaires; D013997:Time Factors; D000092464:Elbow Injuries