Perry F, Parker R K, White P F, Clifford P A
Department of Anesthesiology, Stanford University, Palo Alto, California.
Clin J Pain. 1994 Mar;10(1):57-63; discussion 82-5. doi: 10.1097/00002508-199403000-00008.
We examined the extent to which preoperative state and trait anxiety, general need to control, need to control analgesia, expectations regarding postoperative pain, and demographic variables predict the severity of postoperative pain, discomfort, anxiety, duration of recovery, and patient-controlled analgesia (PCA) behaviors.
Preoperative and outcome variables were analyzed using Pearson product-moment correlations and forward stepwise multiple linear regression.
This study was conducted at a university hospital in preoperative and postoperative settings.
Ninety-nine consecutively consenting ASA physical status I-II women (age 46 +/- 11 years, 70% caucasian, 28% Afro-American, 2% Hispanic) undergoing simple hysterectomy procedures with no known cancer were included in the study.
Standardized general anesthesia, surgery, and PCA therapy was conducted.
The McGill Pain Questionnaire (MPQ), patient requests and delivered analgesic medication, visual analog scales (VAS) for pain and anxiety, time to oral medications and hospital discharge, and Likert scale measurements of overall pain and discomfort were utilized.
Older patients generally reported less pain, but used the same amount of analgesic medication as younger patients. Preoperative trait anxiety correlated with increased PCA requests, but not with postoperative pain. In contrast, preoperative state anxiety correlated positively with postoperative pain and with shorter time to hospital discharge. The patients' need for control was positively correlated with the Present Plan Index scale of the MPQ, with morphine requirement, and with PCA requests.
Psychological factors do influence postoperative recovery and pain control in women receiving PCA therapy after abdominal hysterectomy, and attention to individual patient differences may lead to improved postoperative outcomes.
我们研究了术前状态焦虑和特质焦虑、总体控制需求、镇痛控制需求、对术后疼痛的预期以及人口统计学变量在多大程度上能够预测术后疼痛的严重程度、不适、焦虑、恢复持续时间以及患者自控镇痛（PCA）行为。
使用Pearson积差相关和向前逐步多元线性回归分析术前和结果变量。
本研究在一家大学医院的术前和术后环境中进行。
99名连续同意参与研究的美国麻醉医师协会（ASA）身体状况为I-II级的女性（年龄46±11岁，70%为白种人，28%为非裔美国人，2%为西班牙裔），她们接受了无已知癌症的简单子宫切除术。
实施标准化的全身麻醉、手术和PCA治疗。
使用麦吉尔疼痛问卷（MPQ）、患者请求和给予的镇痛药物、疼痛和焦虑的视觉模拟量表（VAS）、开始口服药物和出院的时间，以及总体疼痛和不适的李克特量表测量。
老年患者通常报告的疼痛较少，但使用的镇痛药物量与年轻患者相同。术前特质焦虑与PCA请求增加相关，但与术后疼痛无关。相比之下，术前状态焦虑与术后疼痛呈正相关，且与住院时间缩短相关。患者的控制需求与MPQ的当前计划指数量表、吗啡需求量和PCA请求呈正相关。
心理因素确实会影响接受腹部子宫切除术后PCA治疗的女性的术后恢复和疼痛控制，关注个体患者差异可能会改善术后结果。
