Abstract
Anxiety, depression, and catastrophizing are generally considered to be predictive
of chronic postoperative pain, but this may not be the case after all types of surgery,
raising the possibility that the results depend on the surgical model. We assessed
the predictive value of these factors for chronic postsurgical pain in 2 different
surgical models: total knee arthroplasty for osteoarthritis (89 patients, 65% women,
age = 69 ± 9 years, baseline pain intensity = 4.7 ± 2.1) and breast surgery for cancer
(100 patients, 100% women, age = 55 ± 12 years, no preoperative pain). Data were collected
before surgery, then 2 days and 3 months after surgery. Anxiety, depression, and catastrophizing
were measured with the Spielberger State-Trait Anxiety Inventory, Beck Depression
Inventory, and Pain Catastrophizing Scale, respectively. Pain was assessed with the
Brief Pain Inventory. Neuropathic pain was detected with the DN4 questionnaire. Multivariate
logistic regression analyses for the total knee arthroplasty and breast surgery models
considered together indicated that the presence of clinically meaningful chronic pain
at 3 months (pain intensity ≥3/10) was predicted independently by age (P = .04), pain intensity on day 2 (P = .009), and state anxiety (P = .001). Linear regression models also showed that pain magnification, one of the
dimensions of catastrophizing, independently predicted chronic pain intensity (P = .04). These results were not affected by the surgical model or by the neuropathic
characteristics of the pain. Thus, state anxiety and pain magnification seem to constitute
psychological risk factors for chronic postsurgical pain relevant in all surgical
models.
Perspective
This prospective study performed in patients with total knee arthroplasty or breast
surgery for cancer shows that state anxiety, amplification of pain, and acute postoperative
pain independently predict postsurgical pain at 3 months and that this does not depend
on the surgical model.
Key words
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Article info
Publication history
Published online: May 20, 2013
Accepted:
February 28,
2013
Received in revised form:
February 27,
2013
Received:
October 2,
2012
Footnotes
Anne Dubois Masselin received funding from the French Society of Pain-Janssen-Cilag for this study.
The authors have no conflicts of interest financial or otherwise, related to this study.
Identification
Copyright
© 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.
