Psychological risk factors for chronic post-surgical pain after inguinal hernia repair surgery: A prospective cohort study

被引:66
作者
Powell, R. [1 ]
Johnston, M.
Smith, W. C.
King, P. M. [3 ]
Chambers, W. A. [4 ]
Krukowski, Z. [3 ]
Mckee, L. [2 ]
Bruce, J. [5 ]
机构
[1] Aston Univ, Sch Life & Hlth Sci, Birmingham B4 7ET, W Midlands, England
[2] Univ Aberdeen, Div Appl Hlth Sci, Hlth Serv Res Unit, Aberdeen AB9 1FX, Scotland
[3] Aberdeen Royal Infirm, Dept Surg, Aberdeen, Scotland
[4] Aberdeen Royal Infirm, Dept Anaesthesia, Aberdeen, Scotland
[5] Univ Warwick, Warwick Clin Trials Unit, Coventry CV4 7AL, W Midlands, England
关键词
FEAR-AVOIDANCE MODEL; DISPOSITIONAL OPTIMISM; PERCEIVED CONTROL; RECOVERY; ANXIETY; SCALE;
D O I
10.1016/j.ejpain.2011.08.010
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
A significant proportion of patients experience chronic post-surgical pain (CPSP) following inguinal hernia surgery. Psychological models are useful in predicting acute pain after surgery, and in predicting the transition from acute to chronic pain in non-surgical contexts. This is a prospective cohort study to investigate psychological (cognitive and emotional) risk factors for CPSP after inguinal hernia surgery. Participants were asked to complete questionnaires before surgery and 1 week and 4 months after surgery. Data collected before surgery and 1 week after surgery were used to predict pain at 4 months. Psychological risk factors assessed included anxiety, depression, fear-avoidance, activity avoidance, catastrophizing, worry about the operation, activity expectations, perceived pain control and optimism. The study included 135 participants; follow-up questionnaires were returned by 119 (88.1%) and 115 (85.2%) participants at 1 week and 4 months after surgery respectively. The incidence of CPSP (pain at 4 months) was 39.5%. After controlling for age, body mass index and surgical variables (e. g. anaesthetic, type of surgery and mesh type used), lower pre-operative optimism was an independent risk factor for CPSP at 4 months; lower pre-operative optimism and lower perceived control over pain at 1 week after surgery predicted higher pain intensity at 4 months. No emotional variables were independently predictive of CPSP. Further research should target these cognitive variables in pre-operative psychological preparation for surgery.
引用
收藏
页码:600 / 610
页数:11
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