Can Postoperative Pain and Analgesic Need be Predicted in Preoperative Period?

KIRDEMİR P., Ozorak O.

TURKIYE KLINIKLERI TIP BILIMLERI DERGISI, vol.31, no.4, pp.951-959, 2011 (SCI-Expanded) identifier


Objective: In this study, we aimed to evaluate the relationship between preoperative pain pressure threshold (PPT), anxiety, cortisol levels and demographic data of the patients and level of postoperative pain and analgesic need. Material and Methods: Fourty ASA I-II patients who would undergo laparascopic cholecystectomy were enrolled in the study after ethical commettee approval and written informed consents were obtained. Preoperative conditional anxiety scale was applied. PPT was measured from 3. and 4. digital pulps of both hands using an algometer. Blood was drawn before and after surgery for cortisol measurements. Postoperatively 50 mg tramadol was given, patient controlled analgesia (PGA) pain pump was inserted by adjusting 10 mg bolus and 10 min lock time. On 10, 20, 30. minutes and 2, 4, 6, 12, 24. hours, visual analogue scale (VAS), number of bolus and pushing the button and given analgesic amounts were recorded. Gender, age, body mass index, education level, experience of anesthesia, conditional anxiety scores, cortisol and PPT levels and postoperative VAS, number of boluses, number of pushing the button and given analgesic amounts were compared. Results: In females PPT was lower than males (p=0.021). Level of PPT was shown to decrease as the education of the patients increased (p=0.016). Number of pushing the button in early postoperative period was significantly higher in the anxious group. Level of anxiety was lower among the ones with high PPT (p=0.03). Conclusion: Postoperative pain and required analgesic amount should be planned preoperatively with physical and psychologic conditions of the patients.