Predictive Pain Tests Good Before Surgery
Reported October 26, 2005
(Ivanhoe Newswire) — Simple tests before surgery can predict the intensity of pain patients will have and how much medication they will need after the surgery.
Peter H. Pan, M.D., from Wake Forest University Baptist Medical Center in Winston-Salem, N.C., says, “Requirements for pain medication and the severity of pain experienced by patients can be influenced by sensitivity to pain, levels of anxiety, age, genetics and expectations about pain. However, few studies have explored whether physical and psychological responses obtained before surgery can be used together to predict the severity of pain and pain medication required after surgery.” Dr. Pan and his colleagues set out to do just that.
Researchers from Wake Forest University evaluated the benefit of a variety of simple tests in 34 women who were scheduled to undergo elective cesarean sections. Two weeks before their operations, women answered questionnaires to measure anxiety, their expectations about pain, and the levels of pain they experienced during pregnancy. The women also underwent a heat test to measure their sensitivity to pain. Heat, ranging from 95 degrees to 122 degrees, was applied to the skin to determine pain threshold, but it did not cause any damage to the patients.
After the women had their surgeries, their pain levels were measured and doctors recorded how much pain medication they required. Results show the best predictor of how many pain medications the women required was a validated questionnaire measuring anxiety. The best predictors of overall pain after surgery were blood pressure readings just before surgery and the women’s responses to the heat test they had before surgery. The heat test helped identify women in the top 20 percent of pain severity and amount of pain medication required after surgery.
Dr. Pan says, “More research is needed to develop a more complete model, but the study shows the potential to identify patients at risk for high pain levels after surgery so we can tailor treatments to improve their quality of care.”