Katz Jennifer, Poleshuck Ellen L, Andrus Carl H, Hogan Laura A, Jung Beth F, Kulick Dale I, Dworkin Robert H
Department of Psychology, State University of New York College at Geneseo, Geneseo, NY, USA Department of Anesthesiology, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA Department of Psychiatry, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA Department of Obstetrics and Gynecology, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA Department of Surgery, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA Purdue Pharma, Stamford, CT, USA Rochester Psychiatric Center, Rochester, NY, USA.
Pain. 2005 Dec 15;119(1-3):16-25. doi: 10.1016/j.pain.2005.09.008. Epub 2005 Nov 17.
Although more severe acute postoperative pain increases the risk of chronic pain following breast cancer surgery, few studies have examined the characteristics of patients who develop greater acute pain. To identify risk factors for acute pain and its persistence one month following breast cancer surgery, a sample of 114 women scheduled for breast cancer surgery was assessed preoperatively for demographic, clinical, and emotional functioning variables that were hypothesized to be associated with acute pain severity. Clinically meaningful postoperative pain was assessed at follow-up interviews 2, 10, and 30 days after surgery. In univariate analyses, the risk of clinically meaningful acute pain was increased among women who were younger, unmarried, had more invasive surgeries, and had greater preoperative emotional distress. In multiple logistic regression analyses, greater preoperative anxiety was the only variable that made an independent contribution to predicting clinically meaningful acute pain at 2 days after surgery whereas younger age, being unmarried, and preoperative anxiety each made an independent contribution to predicting clinically meaningful acute pain that persisted from 2 to 30 days after surgery. These results increase understanding of neurobiologic mechanisms and psychosocial processes that contribute to the development of acute pain following breast cancer surgery and have implications for the development of interventions to prevent it.
尽管乳腺癌手术后更严重的急性术后疼痛会增加慢性疼痛的风险，但很少有研究探讨发生更剧烈急性疼痛的患者特征。为了确定乳腺癌手术后急性疼痛及其持续一个月的危险因素，对114名计划接受乳腺癌手术的女性样本在术前评估了假设与急性疼痛严重程度相关的人口统计学、临床和情绪功能变量。在术后2天、10天和30天的随访访谈中评估具有临床意义的术后疼痛。在单变量分析中，年龄较小、未婚、接受更多侵入性手术以及术前情绪困扰更大的女性发生具有临床意义的急性疼痛的风险增加。在多元逻辑回归分析中，术前焦虑程度更高是术后2天预测具有临床意义的急性疼痛的唯一独立变量，而年龄较小、未婚和术前焦虑各自对预测术后2至30天持续存在的具有临床意义的急性疼痛有独立贡献。这些结果增进了对导致乳腺癌手术后急性疼痛发生的神经生物学机制和社会心理过程的理解，并对预防急性疼痛的干预措施的制定具有启示意义。
