Associations between postoperative analgesic consumption and distress tolerance, anxiety, depression, and pain catastrophizing: a prospective observational study

Tapar, Hakan; Özsoy, Zeki; Balta, Mehtap Gürler; Daşıran, Fatih; Tapar, Gülşen Genç; Karaman, Tuğba

doi:10.1016/j.bjane.2021.07.007

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Brazilian Journal of Anesthesiology

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Sumário

Original Investigation • Braz. J. Anesthesiol. 72 (5) • Sep-Oct 2022 • https://doi.org/10.1016/j.bjane.2021.07.007 copy

Associations between postoperative analgesic consumption and distress tolerance, anxiety, depression, and pain catastrophizing: a prospective observational study^☆ ☆ This study was presented in the Turkish Anesthesiology and Reanimation Congress, November 7-10, 2019.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background

Patients’ postoperative treatment might be affected by their psychological state. The study aimed to evaluate the effects of anxiety, coping ability (stress tolerance), depression, and pain catastrophizing on analgesic consumption in patients scheduled for sleeve gastrectomy.

Methods

This prospective observational study consisted of 72 patients. The Distress Tolerance Scale (DTS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Pain Catastrophizing Scale (PCS) were completed in the preoperative period. In the postoperative period, pain intensity, as measured with the Visual Analogue Scale (VAS), and morphine consumption (mg) were evaluated after 2, 6, 8, and 24 hours. Total morphine consumption was recorded.

Results

The results revealed a strong negative correlation between distress tolerance and postoperative total morphine consumption (r = -0.702, p< 0.001). There was a strong positive correlation between total morphine consumption and pain catastrophizing (r = 0.801, p< 0.001). A moderate positive correlation was observed between total morphine consumption and anxiety and between total morphine consumption and depression (r = 0.511, p< 0.001; r = 0.556, p< 0.001, respectively). Linear regression revealed that distress tolerance, anxiety, depression, and pain catastrophizing are predictors of postoperative morphine consumption (β = 0.597, p< 0.001; β = 0.207, p= 0.036; β = 0.140, p= 0.208; β = 0.624, p< 0.001, respectively).

Conclusions

Distress tolerance, anxiety, depression, and pain catastrophizing can be predictive of postoperative analgesic consumption. In the estimation of postoperative analgesic consumption, distress tolerance, as well as anxiety, depression, and pain catastrophizing, were found to be important predictors.

Keywords
Anxiety; Depression; Distress tolerance; Pain catastrophizing; Pain; Analgesia

Variable			n	%	Mean (SD)
Demographics	Gender	Male	19	26.4
		Female	53	73.6
	Age (years)				35.5 (10.1)
	Weight (kg)				125.5 (24.9)
	Height (cm)				165.7 (9.9)
	BMI (kg.m^-2)				45.5 (6.3)
Predictors	Distress tolarance				49.1 (14.2)
	Anxiety				22.4 (15.9)
	Depression				8.2 (9.3)
	Pain catastrophizing				18.5 (12.1)
Outcomes	VAS pain recovery room				4.6 (1.8)
	VAS pain at 2 h				4.9 (1.6)
	VAS pain at 6 h				3.8 (1.7)
	VAS pain at 8 h				3.4 (1.6)
	VAS pain at 24 h				2.4 (1.3)
	Morphine consumption at recovery room				2.6 (3.6)
	Morphine consumption at 2 h				3.3 (1.9)
	Morphine consumption at 6 h				2.0 (1.9)
	Morphine consumption at 8 h				1.8 (1.9)
	Morphine consumption at 24 h				1.0 (1.4)
	Total morphine consumption (mg)				10.7 (8.1)

Predictors	Predictors or outcomes	n	Correlation coefficients	p value
Distress tolerance	Anxiety	72	-0.510	<0.001
	Depression	72	-0.645	<0.001
	Pain catastrophizing	72	-0.791	<0.001
	VAS pain in the recovery room	72	-0.516	<0.001
	VAS pain at 2 h	72	-0.483	<0.001
	VAS pain at 6 h	72	-0.628	<0.001
	VAS pain at 8 h	72	-0.671	<0.001
	VAS pain at 24 h	72	-0.690	<0.001
	Morphine consumption in the recovery room (mg)	72	-0.543	<0.001
	Morphine consumption at 2 h (mg)	72	-0.468	<0.001
	Morphine consumption at 6 h (mg)	72	-0.642	<0.001
	Morphine consumption at 8 h (mg)	72	-0.705	<0.001
	Morphine consumption at 24 h (mg)	72	-0.726	<0.001
	Total morphine consumption (mg)	72	-0.702	<0.001
Anxiety	VAS pain in the recovery room	72	0.359	0.002
	VAS pain at 2 h	72	0.641	<0.001
	VAS pain at 6 h	72	0.395	<0.001
	VAS pain at 8 h	72	0.467	<0.001
	VAS pain at 24 h	72	0.608	<0.001
	Morphine consumption in the recovery room (mg)	72	0.330	0.005
	Morphine consumption at 2 h (mg)	72	0.512	<0.001
	Morphine consumption at 6 h (mg)	72	0.422	<0.001
	Morphine consumption at 8 h (mg)	72	0.477	<0.001
	Morphine consumption at 24 h (mg)	72	0.493	<0.001
	Total morphine consumption (mg)	72	0.511	<0.001
Depression	VAS pain in the recovery room	72	0.548	<0.001
	VAS pain at 2 h	72	0.486	<0.001
	VAS pain at 6 h	72	0.512	<0.001
	VAS pain at 8 h	72	0.551	<0.001
	VAS pain at 24 h	72	0.544	<0.001
	Morphine consumption in the recovery room (mg)	72	0.515	<0.001
	Morphine consumption at 2 h (mg)	72	0.388	<0.001
	Morphine consumption at 6 h (mg)	72	0.415	<0.001
	Morphine consumption at 8 h (mg)	72	0.568	<0.001
	Morphine consumption at 24 h (mg)	72	0.558	<0.001
	Total morphine consumption (mg)	72	0.556	<0.001
Pain catastrophizing	VAS pain in the recovery room	72	0.588	<0.001
	VAS pain at 2 h	72	0.651	<0.001
	VAS pain at 6 h	72	0.717	<0.001
	VAS pain at 8 h	72	0.779	<0.001
	VAS pain at 24 h	72	0.775	<0.001
	Morphine consumption at recovery room (mg)	72	0.613	<0.001
	Morphine consumption at 2 h (mg)	72	0.589	<0.001
	Morphine consumption at 6 h (mg)	72	0.733	<0.001
	Morphine consumption at 8 h (mg)	72	0.805	<0.001
	Morphine consumption at 24 h (mg)	72	0.760	<0.001
	Total morphine consumption (mg)	72	0.801	<0.001
VAS pain	Morphine consumption at recovery room (mg)	72	0.907	<0.001
	Morphine consumption at 2 h (mg)	72	0.887	<0.001
	Morphine consumption at 6 h (mg)	72	0.914	<0.001
	Morphine consumption at 8 h (mg)	72	0.906	<0.001
	Morphine consumption at 24 h (mg)	72	0.858	<0.001
	Total morphine consumption (mg)	72	0.950	<0.001

Outcome	Predictors	N	β	p value
Total morphine consumption (mg)	Distress tolerance	72	-0.597	<0.001
	Anxiety	72	-0.207	0.036
	Depression	72	0.140	0.208
	Pain catastrophizing	72	0.624	<0.001

Sociedade Brasileira de Anestesiologia (SBA) Rua Professor Alfredo Gomes, 36, Botafogo , cep: 22251-080 - Rio de Janeiro - RJ / Brasil , tel: +55 (21) 97977-0024 - Rio de Janeiro - RJ - Brazil
E-mail: editor.bjan@sbahq.org

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[1] ☆
This study was presented in the Turkish Anesthesiology and Reanimation Congress, November 7-10, 2019.

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Associations between postoperative analgesic consumption and distress tolerance, anxiety, depression, and pain catastrophizing: a prospective observational study☆ ☆ This study was presented in the Turkish Anesthesiology and Reanimation Congress, November 7-10, 2019.

Abstract

Background

Methods

Results

Conclusions

Associations between postoperative analgesic consumption and distress tolerance, anxiety, depression, and pain catastrophizing: a prospective observational study^☆ ☆ This study was presented in the Turkish Anesthesiology and Reanimation Congress, November 7-10, 2019.