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Updated: Apr 19, 2026
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Prediction of postoperative pain after Mohs micrographic surgery with 2 validated pain anxiety scales
Andrea F Chen1, David C Landy, Erik Kumetz
1*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.
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).
Materials And 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.
Conclusion:
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.
Insights
Pain anxiety significantly increases postoperative pain after Mohs micrographic surgery (MMS), even in dermatologic procedures. While most patients experience minimal discomfort, high pain anxiety predicts greater pain levels, highlighting its importance in surgical outcomes.
Area of Science:
- Dermatologic Surgery
- Pain Management
- Psychological Impact on Pain
Background:
- Preoperative anxiety is linked to increased postoperative pain in various surgical fields.
- Validated questionnaires like the Pain Catastrophizing Scale (PCS) and Pain Anxiety Symptoms Scale (PASS) measure pain anxiety.
- The relationship between pain anxiety and postoperative pain has not been established in dermatologic surgery.
Purpose of the Study:
- To determine if pain anxiety predicts postoperative pain following Mohs micrographic surgery (MMS).
Main Methods:
- 356 patients undergoing MMS at two private practices completed the PCS and PASS questionnaires.
- Postoperative pain levels were assessed after the Mohs micrographic surgery procedure.
Main Results:
- Most patients reported low levels of postoperative pain after MMS.
- Higher scores on pain anxiety scales (PCS and PASS) correlated with significantly greater postoperative pain.
- Female gender, lower extremity surgical site, and certain repair types also influenced pain levels.
Conclusions:
- Pain anxiety is a significant predictor of postoperative pain in dermatologic surgery, including MMS.
- MMS remains a safe and effective procedure with generally minimal postoperative discomfort.
- Addressing patient anxiety is crucial for optimizing pain management after dermatologic surgery.
