Prediction of Acute Postoperative Pain Following Breast Cancer Surgery Using the Pain Sensitivity Questionnaire: A Cohort Study

Abstract

Objectives: Previous studies have indicated that preoperative pain sensitivity correlates with postoperative pain intensity, and thus may be used to predict severe postoperative pain. Self-rating of pain sensitivity using the "Pain Sensitivity Questionnaire (PSQ)" may be an adjunct to these measures.

Methods: We tested the predictive ability of the PSQ as well as experimental parameters of pain sensitivity and other known risk factors for acute pain in 198 patients scheduled for breast cancer surgery. A multivariable logistic regression model was created for the binary outcome "maximum pain >3 during the first 24 hours postoperatively."

Results: The PSQ score proved to be an independent risk factor for at least moderate pain during the first 24 hours after surgery. Univariate analysis yielded in addition younger age, type of surgery (mastectomy vs. breast-conserving surgery), axillary dissection, expected pain, and the anxiety scores of the State-Trait Anxiety Inventory, as well as the score of the Beck Depression Inventory as risk factors. Of the experimental parameters of pain sensitivity, only the pain intensity elicited by a hot water bath was a predictor of at least moderate postoperative pain. Multivariable analysis led to a parsimonious model including only PSQ, the State-Trait Anxiety Inventory state score with a cutoff of ≥30, age with a cutoff of <55, mastectomy (vs. breast-conserving surgery), and axillary dissection.

Discussion: Results need to be validated in a larger cohort and for other types of surgery, but use of the simple PSQ may help to identify patients at risk of intense acute postoperative pain.