title: Prediction of postoperative pain after Mohs micrographic surgery with 2 validated pain anxiety scales.
abstract: BACKGROUND
  Anxiety toward pain has been shown in several studies to increase postoperative pain after surgical procedures. This anxiety can be measured by several validated questionnaires, the Pain Catastrophizing Scale (PCS) and the Pain Anxiety Symptoms Scale (PASS). Higher scores on these scales correlate with increased pain after surgery, but this has not yet been demonstrated in dermatologic surgery.
  
  
  OBJECTIVE
  To assess whether pain anxiety will predict postoperative pain after Mohs micrographic surgery (MMS).
  
  
  METHODS
  Patients at 2 private Mohs practices were recruited to fill out 2 pain questionnaires, the PCS and the PASS. Their postoperative pain was assessed after MMS.
  
  
  RESULTS
  Three hundred fifty-six patients completed the study. Overall, most patients experienced little postoperative pain after Mohs surgery. However, for people with high anxiety toward pain, they also experienced statistically significant greater postoperative pain. Other factors that contributed to greater postoperative pain included female gender and lower extremity location. Second intention healing had lower pain than other repair types.
  
  
  CONCLUSIONS
  This study shows that postoperative pain is affected by pain anxiety, even in dermatologic surgery. However, most patients still had very little discomfort after surgery, further supporting MMS as an effective and safe procedure with relatively few postoperative problems.
authors.affiliation: *Department of Dermatology, The Rendon Center for Dermatology, Boca Raton, Florida; †School of Medicine, University of Miami, Miami, Florida; ‡Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida; §Skin Institute of South Florida, Coral Springs, Florida.
authors.forename: Andrea F
authors.initials: AF
authors.lastname: Chen
authors.forename: David C
authors.initials: DC
authors.lastname: Landy
authors.forename: Erik
authors.initials: E
authors.lastname: Kumetz
authors.forename: Gerard
authors.initials: G
authors.lastname: Smith
authors.forename: Eduardo
authors.initials: E
authors.lastname: Weiss
authors.forename: Eli R
authors.initials: ER
authors.lastname: Saleeby
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology*; D002280:Basal Cell Carcinoma / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000009:adverse effects*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D012878:Skin Neoplasms / Q000601:surgery*