Does expecting more pain make it more intense? Factors associated with the first week pain trajectories after breast cancer surgery

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http://hdl.handle.net/10138/199196

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Sipila , R M , Haasio , L , Meretoja , T J , Ripatti , S , Estlander , A-M & Kalso , E A 2017 , ' Does expecting more pain make it more intense? Factors associated with the first week pain trajectories after breast cancer surgery ' , Pain , vol. 158 , no. 5 , pp. 922-930 . https://doi.org/10.1097/j.pain.0000000000000859

Title: Does expecting more pain make it more intense? Factors associated with the first week pain trajectories after breast cancer surgery
Author: Sipila, Reetta M.; Haasio, Lassi; Meretoja, Tuomo J.; Ripatti, Samuli; Estlander, Ann-Mari; Kalso, Eija A.
Contributor: University of Helsinki, Department of Surgery
University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, Clinicum
Date: 2017-05
Language: eng
Number of pages: 9
Belongs to series: Pain
ISSN: 0304-3959
URI: http://hdl.handle.net/10138/199196
Abstract: The aim of this study was to identify clinical risk factors for unfavorable pain trajectories after breast cancer surgery, to better understand the association between pain expectation, psychological distress, and acute postoperative pain. This prospective study included 563 women treated for breast cancer. Psychological data included questionnaires for depressive symptoms and anxiety. Experimental pain tests for heat and cold were performed before surgery. The amount of oxycodone needed for satisfactory pain relief after surgery was recorded. Pain intensity in the area of operation before surgery and during the first postoperative week and expected intensity of postoperative pain were recorded using the Numerical Rating Scale (NRS 0-10). Pain trajectories were formed to describe both initial intensity (the intercept) and the direction of the pain path (the slope). Factors associated with higher initial pain intensity (the intercept) were the amount of oxycodone needed for adequate analgesia, psychological distress, type of axillary surgery, preoperative pain in the area of the operation, and expectation of postoperative pain. The higher the pain initially was, the faster it resolved over the week. Expectation of severe postoperative pain was associated with higher scores of both experimental and clinical pain intensity and psychological factors. The results confirm that acute pain after breast cancer surgery is a multidimensional phenomenon. Psychological distress, pain expectation, and the patients' report of preoperative pain in the area to be operated should be recognized before surgery. Patients having axillary clearance need more efficient analgesic approaches.
Subject: Acute pain trajectories
Breast cancer
Pain expectation
Psychological distress
CHRONIC POSTSURGICAL PAIN
ACUTE POSTOPERATIVE PAIN
PERSISTENT PAIN
PREDICTIVE FACTORS
RISK-FACTORS
PREOPERATIVE PREDICTORS
EXPECTATIONS
EXPECTANCY
MECHANISMS
EXPERIENCE
3126 Surgery, anesthesiology, intensive care, radiology
3124 Neurology and psychiatry
3112 Neurosciences
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