title: Prospective clinical observational study evaluating gender-associated differences of preoperative pain intensity.
abstract: Previous studies reported conflicting results concerning different pain perceptions of men and women. Recent research found higher pain levels in men after major surgery, contrasted by women after minor procedures. This trial investigates differences in self-reported preoperative pain intensity between genders before surgery.Patients were enrolled in 2011 and 2012 presenting for preoperative evaluation at the anesthesiological assessment clinic at Charité University hospital. Out of 5102 patients completing a computer-assisted self-assessment, 3042 surgical patients with any preoperative pain were included into this prospective observational clinical study. Preoperative pain intensity (0-100 VAS, visual analog scale) was evaluated integrating psychological cofactors into analysis.Women reported higher preoperative pain intensity than men with median VAS scores of 30 (25th-75th percentiles: 10-52) versus 21 (10-46) (P < 0.001). Adjusted multiple regression analysis showed that female gender remained statistically significantly associated with higher pain intensity (P < 0.001). Gender differences were consistent across several subgroups especially with varying patterns in elderly. Women scheduled for minor and moderate surgical procedures showed largest differences in overall pain compared to men.This large clinical study observed significantly higher preoperative pain intensity in female surgical patients. This gender difference was larger in the elderly potentially contradicting the current hypothesis of a primary sex-hormone derived effect. The observed variability in specific patient subgroups may help to explain heterogeneous findings of previous studies.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitaetsmedizin Berlin Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Hospital Wolfenbuettel gGmbH, Wolfenbuettel Department of Anaesthesiology, Intensive Care and Pain Medicine, Hospital Waldfriede, Berlin Department of Biostatistics, Clinical Research Unit, Berlin Institute of Health, Charité- Universitaetsmedizin Berlin, Germany.
authors.forename: Sascha
authors.initials: S
authors.lastname: Tafelski
authors.forename: Léonie F
authors.initials: LF
authors.lastname: Kerper
authors.forename: Anna-Lena
authors.initials: AL
authors.lastname: Salz
authors.forename: Claudia
authors.initials: C
authors.lastname: Spies
authors.forename: Eva
authors.initials: E
authors.lastname: Reuter
authors.forename: Irit
authors.initials: I
authors.lastname: Nachtigall
authors.forename: Michael
authors.initials: M
authors.lastname: Schäfer
authors.forename: Alexander
authors.initials: A
authors.lastname: Krannich
authors.forename: Henning
authors.initials: H
authors.lastname: Krampe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017558:Elective Surgical Procedures; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D057234:Preoperative Period; D011446:Prospective Studies; D012737:Sex Factors