The Open Pain Journal
2013, 6 : 176-182Published online 2013 July 12. DOI: 10.2174/1876386301306010176
Publisher ID: TOPAINJ-6-176
RESEARCH ARTICLE
The Role of Pain Catastrophizing in the Prediction of Acute and Chronic Postoperative Pain
2 Faculty of Welfare and Health Sciences, University of Haifa, Haifa, Israel
3 Department of Neurology, Rambam Health Care Campus, and Laboratory of Clinical Neurophysiology, Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
* Address correspondence to this author at the Faculty of Welfare and Health Sciences, University of Haifa, Mount Carmel, Haifa 31905, Israel; Tel: + 972 4 828 8006; Fax: + 972 4 828 8017; E-mail: granot@research.haifa.ac.il
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.