RESEARCH ARTICLE
The Role of Pain Catastrophizing in the Prediction of Acute and Chronic Postoperative Pain
Ran Kremer1, Michal Granot2, *, David Yarnitsky3, Yonathan Crispel3, Shiri Fadel3, Lael Anson Best1, Rony-Reuven Nir3
Article Information
Identifiers and Pagination:
Year: 2013Volume: 6
First Page: 176
Last Page: 182
Publisher ID: TOPAINJ-6-176
DOI: 10.2174/1876386301306010176
Article History:
Received Date: 10/02/2013Revision Received Date: 04/06/2013
Acceptance Date: 20/06/2013
Electronic publication date: 12/7/2013
Collection year: 2013
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background and Objectives:
Despite the established association between greater pain catastrophizing and enhanced postoperative pain, it is still unclear: (i) what is the relative contribution of each of the pain catastrophizing scale (PCS) dimensions in the prediction of acute and chronic postoperative pain; and (ii) whether PCS scores mediate the association between acute and chronic postoperative pain intensity.
Methods:
The current prospective, observational study was conducted at Rambam Health Care Campus, Haifa, Israel. PCS was obtained in 48 pain-free patients a day before an elective thoracotomy in response to tonic heat pain. Acute postthoracotomy pain (APTP) was assessed during rest, including general pain (Restgeneral), and incision-related pain (Restincision), and in response to provoked physical activity, including hand elevation (Provokedhand) and cough (Provokedcough). Chronic postthoracotomy pain (CPTP) was assessed after 4.5±2.3 months.
Results:
Of the PCS subscales, only rumination: (i) was correlated with Restgeneral scores (r=0.337, P=0.027); and (ii) predicted chronic postthoracotomy pain in a regression analysis (P=0.001). General PCS and its subscales mediated the correlation between Restgeneral and chronic postthoracotomy pain intensity (Ps<0.006).
Conclusions:
Findings may elucidate the unique role of the rumination subscale in reflecting an individual's postopertive acute and chronic pain responsiveness. The transition from acute to chronic postoperative pain seems to be facilitated by enhanced pain catastrophizing.