Physiological Psychology, Otto-Friedrich University, Bamberg, Germany Pain Center, Friedrich-Alexander University, Erlangen, Germany Department of Pediatric Surgery, Friedrich-Alexander University, Erlangen, Germany.
Pain. 2013 Dec;154(12):2737-2744. doi: 10.1016/j.pain.2013.08.005. Epub 2013 Aug 8.
Pain experiences, learning, and genetic factors have been proposed to shape attentional and emotional processes related to pain. We aimed at investigating whether a singular major pain experience also changes cognitive-emotional processing. The influence of acute postoperative pain after cosmetic surgery of the thorax was tested in 80 preoperatively pain-free male individuals. Acute pain was measured as independent variable during the first week postsurgery by pain intensity ratings and the requested analgesic boluses (Patient-Controlled Epidural Analgesia (PCEA)). Pain catastrophizing (Pain Catastrophizing Scale (PCS)), pain anxiety (Pain Anxiety and Symptom Scale (PASS)), pain hypervigilance (Pain Vigilance and Awareness Questionnaire (PVAQ)), and attentional biases to emotionally loaded stimuli (including pain) in a dot-probe task were assessed 1 week, 3 months, and 6 months postsurgery as dependent variables. Hierarchical regression analyses were performed to test whether the 2 acute pain parameters can predict these cognitive-emotional variables. As a rigorous test, significant prediction was required in addition to the prediction of the dependent variables by themselves with lag-1. Acute pain (mainly the pain ratings) appeared to be a significant predictor for PCS, PASS, and PVAQ 1 week after surgery (deltaR(2) = [8.7% to 11.3%]). In contrast, the attentional biases in the dot-probe task could not be predicted by the pain ratings. The levels of pain catastrophizing and pain hypervigilance increased in the acute phase after surgery when influenced by acute pain and declined, along with pain anxiety, during the next 3 months. In conclusion, a one-time intense pain experience, such as acute postoperative pain, appeared to produce at least short-lived changes in the attentional and emotional processing of pain.
疼痛体验、学习和遗传因素被认为会影响与疼痛相关的注意力和情绪过程。我们旨在研究单次主要疼痛经历是否也会改变认知-情绪处理。在 80 名术前无疼痛的男性个体中，测试了胸部美容手术后急性术后疼痛的影响。通过术后第一周的疼痛强度评分和请求的镇痛推注（患者自控硬膜外镇痛（PCEA））来测量急性疼痛作为独立变量。在手术后 1 周、3 个月和 6 个月评估疼痛灾难化（疼痛灾难化量表（PCS））、疼痛焦虑（疼痛焦虑和症状量表（PASS））、疼痛警觉（疼痛警觉和意识问卷（PVAQ））和对情绪负荷刺激（包括疼痛）的注意力偏向作为因变量。进行分层回归分析以测试两个急性疼痛参数是否可以预测这些认知-情绪变量。作为严格的测试，除了依赖变量自身的滞后 1 预测外，还需要有显著的预测。急性疼痛（主要是疼痛评分）在手术后 1 周时似乎是 PCS、PASS 和 PVAQ 的显著预测因子（deltaR(2) = [8.7%至 11.3%]）。相比之下，在 dot-probe 任务中的注意力偏向不能通过疼痛评分来预测。在手术的急性阶段，当受到急性疼痛影响时，疼痛灾难化和疼痛警觉水平增加，而疼痛焦虑则在接下来的 3 个月内下降。总之，单次强烈的疼痛体验，如急性术后疼痛，似乎会导致疼痛的注意力和情绪处理至少产生短暂的变化。
