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Catastrophizing: a risk factor for postsurgical pain.

D Janet Pavlin1, Michael J L Sullivan, Peter R Freund

  • 1Department of Anesthesiology, University of Washington School of Medicine, Seattle, Washington 98195, USA. jpavlin@u.washington.edu

The Clinical Journal of Pain
|December 16, 2004
PubMed
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Pre-surgery pain catastrophizing predicts higher acute postsurgical pain after ACL repair. However, it did not predict postsurgical analgesic use in this study.

Area of Science:

  • Orthopedic Surgery
  • Pain Medicine
  • Psychology

Background:

  • Postsurgical pain management remains a challenge.
  • Patient psychological factors can influence pain perception and outcomes.
  • Catastrophizing, a negative cognitive-affective response to pain, is a potential predictor of pain experiences.

Purpose of the Study:

  • To investigate the predictive value of presurgical pain catastrophizing on postsurgical pain intensity and analgesic consumption.
  • To test the hypothesis that higher presurgical catastrophizing scores correlate with increased postsurgical pain.

Main Methods:

  • A cohort of 48 patients undergoing anterior cruciate ligament repair completed the Pain Catastrophizing Scale pre-surgery.
  • Pain intensity was assessed using a 0-10 scale in the postanesthetic care unit and at 1, 2, and 7 days post-surgery.

Related Experiment Videos

  • Analgesic consumption (opioid and nonopioid) was recorded during hospitalization and after discharge.

    • Main Results:

    • Presurgical Pain Catastrophizing Scale scores significantly predicted acute postsurgical pain in the postanesthetic care unit (r = 0.48, P = 0.004).
    • Patients with high catastrophizing scores reported numerically higher pain (33-74% increase) and longer duration of moderate-severe pain.
    • Catastrophizing also predicted pain with activity at 24 hours (r = 0.65, P < 0.0001), but not postsurgical analgesic use.

    Conclusions:

    • Elevated presurgical pain catastrophizing is a risk factor for heightened acute postsurgical pain following ACL repair.
    • Psychological assessments like the Pain Catastrophizing Scale may aid in identifying patients at risk for severe postsurgical pain.
    • Findings highlight the importance of psychological factors in the postsurgical pain experience.