Preoperative Pain/Anxiety May Lead to Postoperative Discomfort

Patients with adolescent idiopathic scoliosis who underwent spinal fusion may experience more postsurgical pain if they have higher preoperative levels of pain or anxiety, according to recently published research.

“Results of this study suggest that salient risk factors for atypically slower rates of improvement in pain after spinal fusion surgery for [adolescent idiopathic scoliosis] AIS include greater preoperative pain and anxiety and poorer pain coping efficacy,” Mark Connelly, Ph.D., and colleagues wrote in the study. “These data help establish an impetus for additional research designed to determine the clinical utility of prescreening patients prior to surgery on variables reliably linked to poorer postoperative pain outcomes.”

The researchers examined postsurgical pain in 50 patients who were between 11 years and 17 years old at two-week, six-week, three-month and six-month follow-up, according to the abstract. On average, pain declined in the days after surgery; however, 22 percent of patients experienced pain equal to or greater than baseline pain at six-month follow-up.

While patients who showed confidence in their ability to control pain were more likely to see a decline in their postsurgical pain, researchers said more analysis was needed to determine whether modifying this behavior reliably improved postsurgical pain.

“In particular, studies are needed to test directly the hypothesis that modifying preoperative pain, anxiety, and/or pain coping efficacy through medical and/or nonpharmacological intervention will lead to durable improved postoperative pain outcomes for those with AIS who are most susceptible to developing ongoing postsurgical pain,” Connelly and colleagues wrote.