Pre- and post-surgical factors that predict the provision of rescue analgesia following hysterectomy

Background To better manage post‐surgical pain, standardized analgesic protocols allow for rescue analgesia (RA). This study seeks to determine which pre‐ and post‐surgical clinical and patient‐related factors, in addition to post‐surgical pain, may influence health care professional decisions on RA...

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Bibliographic Details
Published in:European journal of pain 2013-03, Vol.17 (3), p.423-433
Main Authors: Pinto, P.R., McIntyre, T., Fonseca, C., Almeida, A., Araújo-Soares, V.
Format: Article
Language:English
Subjects:
Adaptation, Psychological
Adult
Age Factors
Aged
Analgesia
Anesthesia
Anxiety - psychology
Catastrophization - psychology
Educational Status
Fear - psychology
Female
Forecasting
Humans
Hysterectomy - adverse effects
Middle Aged
Pain, Postoperative - drug therapy
Pain, Postoperative - epidemiology
Pain, Postoperative - psychology
Postoperative Nausea and Vomiting - complications
Postoperative Nausea and Vomiting - therapy
Predictive Value of Tests
Preoperative Period
Pruritus - complications
Pruritus - therapy
Psychiatric Status Rating Scales
Socioeconomic Factors
Surveys and Questionnaires
Treatment Outcome
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Summary:Background To better manage post‐surgical pain, standardized analgesic protocols allow for rescue analgesia (RA). This study seeks to determine which pre‐ and post‐surgical clinical and patient‐related factors, in addition to post‐surgical pain, may influence health care professional decisions on RA administration. Methods A consecutive sample of 185 women, submitted to hysterectomy for benign disorders, was assessed 24 h before (time 1; T1) and 48 h after (time 2; T2) surgery. At T1, baseline demographic, clinical and psychological predictors were assessed and at T2, post‐surgical pain, anxiety and RA administration were recorded. Results After controlling for post‐surgical acute pain intensity, logistic regression results revealed several pre‐surgical (T1) and surgical factors associated with post‐surgical RA: having other previous pain states [odds ratio (OR), 4.551; 95% confidence interval (CI), 1.642–12.611, p = 0.004], being anaesthetized with only general or loco‐regional anaesthesia (OR, 5.349; 95% CI, 1.976–14.483, p = 0.001) and pre‐surgical fear of immediate consequences of surgery (OR, 1.306; 95% CI, 1.031–1.655, p = 0.027). Concerning post‐surgical variables, higher pain intensity (OR, 1.591; 95% CI, 1.353–1.871, p 
ISSN:1090-3801
1532-2149
DOI:10.1002/j.1532-2149.2012.00205.x