Pain threshold and pain tolerance as predictors of acute postoperative pain: Pain threshold and pain tolerance

Abstract

Introduction Acute postoperative pain can lead to various complications, affecting cardiovascular, respiratory , gastrointestinal, and renal systems, increases the costs of treatment and affects patient satisfaction. The pain prediction contributes to optimization of acute pain treatment with pain threshold and tolerance serving as key predictors of pain. Pain threshold measures the intensity of a stimulus causing pain, while pain tolerance is the maximum pain a person can endure. Objective/Aim This review aims to investigate whether pain threshold and pain tolerance can predict the intensity of acute postoperative pain. Methods We assessed published data on pain threshold, tolerance and acute postoperative pain from the past 10 years. Five relevant studies were included after screening 26 papers. Various study types were considered, including systematic reviews, prospective observational and randomized control studies. Results Patients with higher preoperative pain tolerance reported higher pain scores postoperatively. Another investigation found that patients with a higher threshold for pressure pain before surgery experienced less pain after surgery. Preoperative pain tolerance strongly predicts intensity of acute postoperative pain. Pain threshold derived from EEG has predictive accuracy for acute postoperative pain. Research on postoperative pain demonstrated that transcutaneous electrical nerve stimulation increased pain thresholds. A systematic review concluded that lower preoperative heat pain thresholds were associated with higher postoperative pain after various surgeries. Conclusion Pain threshold and pain tolerance could serve as good predic-tors of acute postoperative pain. While these tests show promise, challenges include time consumption and resource demands. Further research is needed to develop cost-effective and time-efficient tests for timely identification of patients at risk for acute postoperative pain.