Preoperative anxiety and postoperative pain in women undergoing hysterectomy - A repeated-measures design

Objectives: To determine whether psychological variables such as preoperati ve anxiety can serve as predictors fur the postoperative pain response. Met hods: The study sample included women who underwent elective abdominal hyst erectomy (n = 53). Two weeks prior to surgery, characteristics such as trai t anxiety, coping style, and perceived stress were evaluated. Throughout th e perioperative period, state anxiety, pain, as well as analgesic consumpti on were assessed at multiple time points. The anesthetic and surgical manag ement were carefully controlled for and postoperative pain management was s tandardized. Results: Path analysis demonstrated that there are both direct and indirect effects of preoperative state anxiety on postoperative pain. Preoperative state anxiety is a significant positive predictor of the immed iate postoperative pain (beta = 0.30), which, in turn, is a positive predic tor of pain on the wards (beta = 0.54). Pain on the ward, in turn, is predi ctive for pain at home (beta = 0.30). Conclusion: The results of this study indicate that preoperative anxiety may have a critical role in the chain-o f-events that controls the postoperative pain response. (C) 2001 Elsevier S cience Inc. All rights reserved.