Association between self-perceived pain sensitivity and pain intensity after cardiac surgery

Abstract

Ann Kristin Bjørnnes,1,2 Irene Lie,3 Monica Parry,2 Ragnhild Falk,4 Marit Leegaard,5 Tone Rustøen,1,6 Berit Taraldsen Valeberg5 1Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway; 2Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada; 3Center for Patient Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway; 4Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway; 5OsloMet – Oslo Metropolitan University, Faculty of Health Sciences, Institute of Nursing, Oslo, Norway; 6Institute of Health and Society, University of Oslo, Oslo, Norway Background and purpose: Cardiac surgical pain remains a clinical challenge affecting about 40% of individuals in the first six months post-cardiac surgery, and continues up to two years after surgery for about 15–20%. Self-perceived sensitivity to pain may help to identify individuals at risk for persistent cardiac surgical pain to optimize health care responses. The purpose of this study was to assess the relationship between self-perceived pain sensitivity assessed by the Pain Sensitivity Questionnaire (PSQ) and postoperative worst pain intensity up to 12 months after cardiac surgery. Sex differences in baseline characteristics and the PSQ scores were also assessed. Methods: This study was performed among 416 individuals (23% women) scheduled for elective coronary artery bypass graft and/or valve surgery between March 2012 and September 2013. A secondary data-analysis was utilized to explore the relationship between preoperative PSQ scores and worst pain intensity rated preoperatively, across postoperative Days 1–4, at 2 weeks, and at 1, 3, 6, and 12 months post-surgery. Linear mixed model analyses were performed to estimate changes in pain intensity during 1-year follow-up. Results: The mean (±standard deviation) PSQ-total score was 3.3±1.4, with similar scores in men and women. The PSQ-total score was significantly associated with higher worst pain intensity ratings adjusted for participant characteristics (p=0.001). Conclusion: Use of the PSQ before surgery may predict cardiac surgical pain intensity. However, previous evidence is limited and not consistent, and more research is needed to substantiate our results. Keywords: postoperative pain, acute pain, persistent pain, pain sensitivity, pain sensitivity questionnaire, cardiac surgery

Keywords

• postoperative pain
• acute pain
• persistent pain
• pain sensitivity
• pain sensitivity questionnaire
• cardiac surgery