Relationship between Preoperative Lower Back Pain and Severe Postoperative Pain after Gynecologic Laparoscopy: A Prospective Observational Study.

We hypothesized that preoperative lower back pain (LBP) may be associated with the severity of postoperative pain after gynecologic laparoscopy. This prospective observational study aimed to investigate the association between preoperative LBP and postoperative pain. We assessed the intensity of LBP before surgery and the postoperative pain after surgery. The abilities of preoperative LBP intensity, age, body mass index, and anesthetic duration time to predict moderate-to-severe postoperative pain were measured using receiver operating characteristic analysis. The data of 148 patients were analyzed. Only preoperative LBP intensity showed a significant association with moderate-to-severe postoperative pain (area under the curve, 0.71; 95% confidence interval, 0.63−0.79; p < 0.001). Preoperative LBP rated three on a numeric rating scale (NRS) had the highest combined sensitivity (75.3%) and specificity (58.3%). Patients with LBP above NRS 3 had more severe postoperative pain than those who did not (pain score 5.3 ± 2.2 vs. 3.9 ± 1.9, p < 0.001), leading to more opioid requirement in the recovery room (48.5% vs. 27.5%, p = 0.014). Preoperative LBP intensity is a useful factor for identifying patients at risk for pain after gynecologic laparoscopy.