Predictors of postoperative pain and analgesic requirements following abdominal hysterectomy: an observational study

Predictors of postoperative pain and analgesic requirements following abdominal hysterectomy: an observational study

Purpose A prospective observational study is conducted to identify independent predictors of pain and morphine consumption following abdominal hysterectomy. Methods Preoperative State Trait Anxiety Inventory (STAI), Numerical Rating Scales (NRS) for anxiety and pain expectations, thermal pain thresh...

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Bibliographic Details
Published in:Journal of anesthesia Vol. 30; no. 1; pp. 72 - 79
Main Authors: Aouad, Marie T., Kanazi, Ghassan E., Malek, Krystel, Tamim, Hani, Zahreddine, Lama, Kaddoum, Roland N.
Format: Journal Article
Language:English
Published: Tokyo Springer Japan 01-02-2016
Springer
Subjects:
Adult
Aged
Analgesics - therapeutic use
Anesthesiology
Anxiety - epidemiology
Care and treatment
Complications and side effects
Critical Care Medicine
Diagnosis
Emergency Medicine
Female
Health aspects
Humans
Hysterectomy
Hysterectomy - methods
Intensive
Medicine
Medicine & Public Health
Middle Aged
Morphine - therapeutic use
Original Article
Pain Measurement
Pain Medicine
Pain, Postoperative - drug therapy
Postoperative pain
Prospective Studies
United States
Morphine consumption
Postoperative pain
Predictors
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Summary:Purpose A prospective observational study is conducted to identify independent predictors of pain and morphine consumption following abdominal hysterectomy. Methods Preoperative State Trait Anxiety Inventory (STAI), Numerical Rating Scales (NRS) for anxiety and pain expectations, thermal pain thresholds and pain scores at forearm and incision site, and pain scores generated from the insertion of an intravenous catheter were measured in female patients undergoing abdominal hysterectomy. Pearson correlations between the predictors and the two outcome measures postoperative pain scores and morphine consumption were studied and multiple regression analysis was conducted to identify independent predictors (primary outcome). Secondary outcomes included cut-off values of predictive tools for morphine consumption. Results Data from 60 patients were analyzed. STAI state anxiety, NRS pain expectations, and NRS anxiety scores were identified as independent predictors of postoperative morphine consumption. We identified a cut-off value of 4.5 (sensitivity 90 %, specificity of 60 %) for the NRS anxiety and a cut-off of 42.5 (sensitivity 70 %, specificity 70 %) for the state anxiety STAI score for increased postoperative morphine consumption. Conclusions Preoperative STAI state anxiety scores and NRS pain expectations are independent predictors for increased morphine consumption following hysterectomy. The STAI state anxiety tool and NRS 0-10 anxiety tool can be used interchangeably. The NRS 0-10 anxiety is a much simpler tool than STAI state anxiety and is associated with a higher sensitivity for high morphine consumption. Thermal pain thresholds and IV pain scores were not predictive of postoperative morphine consumption.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ISSN:0913-8668
1438-8359
DOI:10.1007/s00540-015-2090-0