Kain Z N, Sevarino F, Alexander G M, Pincus S, Mayes L C
Department of Anesthesiology, Yale University, New Haven, CT 06520, USA.
J Psychosom Res. 2000 Dec;49(6):417-22. doi: 10.1016/s0022-3999(00)00189-6.
To determine whether psychological variables such as preoperative anxiety can serve as predictors for the postoperative pain response.
The study sample included women who underwent elective abdominal hysterectomy (n=53). Two weeks prior to surgery, characteristics such as trait anxiety, coping style, and perceived stress were evaluated. Throughout the perioperative period, state anxiety, pain, as well as analgesic consumption were assessed at multiple time points. The anesthetic and surgical management were carefully controlled for and postoperative pain management was standardized.
Path analysis demonstrated that there are both direct and indirect effects of preoperative state anxiety on postoperative pain. Preoperative state anxiety is a significant positive predictor of the immediate postoperative pain (beta=0.30), which, in turn, is a positive predictor of pain on the wards (beta=0.54). Pain on the ward, in turn, is predictive for pain at home (beta=0.30).
The results of this study indicate that preoperative anxiety may have a critical role in the chain-of-events that controls the postoperative pain response.
确定术前焦虑等心理变量是否可作为术后疼痛反应的预测指标。
研究样本包括接受择期腹部子宫切除术的女性（n = 53）。手术前两周，评估特质焦虑、应对方式和感知压力等特征。在整个围手术期，在多个时间点评估状态焦虑、疼痛以及镇痛药物的消耗量。对麻醉和手术管理进行了严格控制，术后疼痛管理实现了标准化。
路径分析表明，术前状态焦虑对术后疼痛既有直接影响，也有间接影响。术前状态焦虑是术后即刻疼痛的显著正向预测指标（β = 0.30），而术后即刻疼痛又是病房疼痛的正向预测指标（β = 0.54）。病房疼痛反过来又可预测居家疼痛（β = 0.30）。
本研究结果表明，术前焦虑可能在控制术后疼痛反应的事件链中起关键作用。
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