Effects of Epidemiological Factors and Pressure Pain Measurements in Predicting Postoperative Pain: A Prospective Survey of 1,002 Chinese Patients.

ABSTRACT

BACKGROUND: A high degree of inter-individual differences was noted in human basal pain as well as the reporting of clinical pain, such as postoperative pain. Understanding the effects of common epidemiological variations and preoperative experimental methods of human pain perception may contribute to individualized pain treatment for patients. OBJECTIVES: The current study was aimed to assess the role of epidemiological factors and preoperative experimental pain sensitivity for predicting postoperative pain and to analyze the potential effects of epidemiological factors on experimental pain sensitivity. STUDY DESIGN: A prospective survey of patients who were scheduled for selective surgery under general anesthesia. SETTING: Department of Anesthesiology at a teaching hospital in a medical college in a major metropolitan city in China. METHODS: One thousand two Chinese patients who were scheduled for selective surgery under general anesthesia were included. The preoperative epidemiology data of all patients were collected by the investigator through face-to-face interviews, and pressure pain, including the pressure pain threshold and tolerance, was tested. Next, the pain intensity and consumption of patient-controlled analgesia during the 48 hours after surgery were followed up. RESULTS: Through regression analysis of the current prospective study, epidemiological factors, including current smoker (P = 0.002), history of surgery (P = 0.038), and lower preoperative pressure pain tolerance (P = 0.001), were identified as independent risk factors for the incidence of postoperative inadequate analgesia. Additionally, from the perspective of the postoperative analgesia outcome, minimally invasive surgery and procedure-specific pain-treatment should be encouraged. Furthermore, several factors, including gender and smoking status, were found to be associated with the postoperative analgesic requirement or basal pressure pain threshold. LIMITATIONS: The limitations of this study include that preoperative psychological tests were not performed. CONCLUSIONS: Preoperatively determining the smoking status and history of surgery might serve as predictors for postoperative analgesia in the Chinese population. Additional preoperative pressure pain measurements might be an effective experimental method for predicting postoperative pain.Key words Epidemiologic, pressure pain, smoking, predicting, surgery, postoperative pain, inadequate analgesia, Chinese population.