An Exploratory Study of the Association Between Preoperative Pain Catastrophizing Scale Scores and Postoperative Pain Experience in Total Knee Arthroplasty

Abstract

AbstractIntroductionOpiate misuse is increasingly common and can result from a single opiate exposure. High pain catastrophizing scores have been linked with greater reported pain and increased opiate use in outpatient studies, but this association has not previously been established in a perioperative setting.MethodsA quantitative, cross-sectional pilot study was conducted on 21 patients undergoing total knee arthroplasty surgery. Pain Catastrophizing Scale (PCS) scores and patients’ ASA Physical Status classifications were collected prior to surgery. Postoperative pain scores were measured using an 11-point numeric rating scale (NRS) and postoperative opiate consumption was measured using modified morphine equivalents (MMEs). Data were analyzed using Spearman rank correlation coefficients.ResultsSignificant correlations were found between NRS pain scores at 6 hours post-surgery and 48 hours post-surgery (.455); and NRS pain scores at 6 hours post-surgery and opiate consumption within the first 24 hours post-surgery (.591). A significant correlation was also found between ASA Physical Status classification and total opiate consumption (.522). While rumination scores within the Pain Catastrophizing Scale were also moderately positively correlated with reported pain scores 12 hours post-surgery (.41) and morphine dosing at 48 hours (.40), they were not significant.ConclusionsEarly preemptive pain management is an important component of overall postoperative pain management and to reduce opiate use. Results support that the ASA Physical Status classification scores may be helpful in identifying patients at risk for high opiate use. For the PCS, more data are needed to determine the clinical usefulness of the PCS as an adjunct to overall postoperative pain management.