Psychological and endocrine factors and pain after mastectomy

Background This prospective study was designed to examine the associations of demographic, clinical, psychological and neuroendocrine factors with acute and chronic post‐operative pain following partial mastectomy. Methods Sixty‐four female patients scheduled for partial mastectomy were enrolled. Pr...

Full description

Saved in:
Bibliographic Details
Published in:European journal of pain 2017-08, Vol.21 (7), p.1144-1153
Main Authors: Nishimura, D., Kosugi, S., Onishi, Y., Ihara, N., Wakaizumi, K., Nagata, H., Yamada, T., Suzuki, T., Hashiguchi, S., Morisaki, H.
Format: Article
Language:English
Subjects:
Acute Pain - physiopathology
Anxiety - psychology
Anxiety Disorders - complications
Chronic Pain - complications
Depression - psychology
Humans
Mastectomy
Pain Measurement
Pain, Postoperative - etiology
Prospective Studies
Stress, Psychological
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background This prospective study was designed to examine the associations of demographic, clinical, psychological and neuroendocrine factors with acute and chronic post‐operative pain following partial mastectomy. Methods Sixty‐four female patients scheduled for partial mastectomy were enrolled. Pre‐operative anxiety/depression was assessed, using the Hospital Anxiety and Depression Scale (HADS). Pre‐operative 24‐h urinary cortisol levels were measured 2 days before surgery. Post‐operative pain was examined using a visual analog scale (VAS) for acute pain on 0–2 post‐operative day (POD), and a short‐form McGill Pain Questionnaire for chronic pain at 6 months after surgery. In the last 29 subjects, post‐operative 24‐h urinary cortisol levels were also measured on 0 POD and were subjected to correlation analysis. Results Multivariate logistic regression analysis revealed that lower pre‐operative cortisol secretion and greater pre‐operative anxiety were significantly associated with an increased risk of moderate to severe acute post‐operative pain [Odds Ratio (95% Confidence Interval); 0.96 (0.92–0.98), and 1.24 (1.04–1.54)], and that patients with greater pre‐operative anxiety and moderate to severe acute pain were more likely to develop chronic post‐operative pain [OR (95% CI); 1.63 (1.23–2.40), and 5.07 (1.30–24.6)]. Correlational analysis demonstrated that the post‐operative cortisol level was inversely correlated with pre‐operative anxiety and the intensity of acute post‐operative pain (r = −0.40, p 
ISSN:1090-3801
1532-2149
DOI:10.1002/ejp.1014