Effects of Preoperative Anxiety, Depression and Pain on Quality of Postoperative Recovery and acute Postoperative Pain after Radical Prostatectomy: a Prospective Observational Study

Abstract

Patients with prostate cancer are often in psychological distress and pain preoperatively. The aim of this study was to examine the effects of preoperative anxiety, depression and pain on the quality of postoperative recovery and acute postoperative pain after radical prostatectomy. One hundred and sixty patients scheduled for open or laparoscopic radical prostatectomy were enrolled in a prospective observational study. Psychological distress was assessed with the State-Trait Anxiety Inventory (STAI-S and STAI-T) and Center for Epidemiological Studies Depression Scale (CES-D). Postoperative recovery was assessed on postoperative days 1-3 using the Quality of Recovery-40 score (QoR-40). Numeric rating scale 0-10 was used to assess the intensity of postoperative pain at rest and on movement at 1, 6 and 24 hours post-surgery. In linear regression models, STAI-S was predictor of QoR-40 on postoperative days 1-3 (ß=-17.32; p<0,001, ß=-0.345; p=0.004, and ß=-0.326; p=0.002, respectively), and preoperative pain was predictor of pain at rest (ß=0.666; p=0.008) and on movement (ß=0.691; p=0.006). In logistic regression models, preoperative pain was predictor of clinically significant pain at rest (OR, 2.86; 95% CI 1.11-7.36) and STAI-S of clinically significant pain on movement (OR, 2.21; 95% CI, 1.08-4.52). In conclusion, state anxiety had negative impact on QoR and acute pain after radical prostatectomy. Preoperative pain was associated with acute postoperative pain.

Keywords

• Anxiety
• Depression
• Pain
• Postoperative recovery
• Prostatectomy