Abstract
Persistent postsurgical pain (PPSP) is a major clinical problem with significant individual,
social, and healthcare costs. The aim of this study was to examine the role of demographic,
clinical, and psychological risk factors in the development of PPSP after hysterectomy
due to benign disorders. In a prospective study, a consecutive sample of 186 women
was assessed 24 hours before surgery (T1), 48 hours after surgery (T2), and 4 months
after surgery (T3). Regression analyses were performed to identify predictors of PPSP.
Four months after hysterectomy, 93 (50%) participants reported experiencing pain (numerical
rating scale >0). Age, pain due to other causes, and type of hysterectomy emerged
as significant predictive factors. Baseline presurgical psychological predictors identified
were anxiety, emotional illness representation of the condition leading to surgery,
and pain catastrophizing. Among the identified psychological predictors, emotional
illness representation emerged as the strongest. Acute postsurgical pain frequency
and postsurgical anxiety also revealed a predictive role in PPSP development. These
results increase the knowledge on PPSP predictors and point healthcare professionals
toward specific intervention targets such as anxiety (presurgical and postsurgical),
pain catastrophizing, emotional illness representations, and acute pain control after
surgery.
Perspective
This study found that presurgical anxiety, emotional illness representations, and
pain catastrophizing are risk factors for PPSP 4 months after hysterectomy, over and
above age and clinical variables. These findings improve knowledge on PPSP and highlight
potential intervention targets for healthcare professionals.
Key words
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Article info
Publication history
Published online: October 15, 2012
Accepted:
July 25,
2012
Received in revised form:
July 15,
2012
Received:
February 24,
2012
Footnotes
We declare that none of the authors have any financial or other relationships that might lead to a conflict of interest. This work was supported by a grant (SFRH/BD/36368/2007) from the Portuguese Foundation of Science and Technology.
Identification
Copyright
© 2012 American Pain Society. Published by Elsevier Inc. All rights reserved.
