How reliable is our memory for acute postoperative pain

Objectiles: Clinicians use patients' reca II of pain as an important source of evidence both in diagnosis and in assessing improvements following trea tment. Yet very little is known about the accuracy of these retrospective a ccounts up to now. Methods: We examined patients' retrospective evaluations of the pain they e xperienced at the first postoperative day and related these evaluations to the pain intensity which was recorded in the PCA-report. Results: We found that recall was moderately accurate. Patients mostly over estimated their pain intensity. We could demonstrate that patients who over estimated their pain differed significantly from those who did not. The pat ients who overestimated showed no significant pain relief over the first th ree postoperative days. Other influences were the pain intensity of the thi rd day and patients' expectations of the postoperative pain intensity. Our results could be embedded within the theoretical framework of general memor y research. Conclusions: We conclude that real-time evaluations of pain intensity shoul d be recorded additionally to retrospective accounts. Retrospective ratings are important too, because we suggest that the memory of pain more than th e experience of pain itself form the basis of patients' future decisions ab out treatment including their compliance and their satisfaction with pain m anagement.