Qualitative aspects of patient pain during surgery with wide-awake local anesthesia

Purpose: Studies assessing intraoperative pain during surgery with wide-awake local anesthesia typically use a unidimensional pain scale, which provides a limited view of the pain experience. The present paper describes two studies that assessed qualitative aspects of intraoperative pain using a multidimensional pain measure. Methods: The first study was a retrospective survey of 24 patients who received a variety of foot and ankle procedures under wide-awake local anesthesia. Patients completed a copy of the Short-Form McGill Pain Questionnaire (SF-MPQ) through the mail an average of six months following surgery. The second study was a prospective assessment of 40 patients receiving forefoot procedures under the same anesthesia. Patients completed a copy of the SF-MPQ directly after the surgery. Results: Patients in the first study selected an average of 1.17 pain descriptors (SD = 3.02) on the SF-MPQ, whereas patients in the second study selected an average of 1.90 pain descriptors (SD = 1.82). In general, both studies found that sensory descriptors of pain (e.g., sharp, shooting, tender) were more common than affective descriptors. However, mean intensity ratings were low for all descriptors. Conclusion: The results of these studies provide a more comprehensive understanding of the patient experience during surgery with wide-awake local anesthesia.