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Prediction of Acute Postoperative Pain Following Breast Cancer Surgery Using the Pain Sensitivity Questionnaire

A Cohort Study

Rehberg, Benno MD; Mathivon, Stanislas BSc; Combescure, Christophe PhD; Mercier, Yannick MD; Savoldelli, Georges L. MD

doi: 10.1097/AJP.0000000000000380
Original Articles

Objectives: Previous studies have indicated that preoperative pain sensitivity correlates with postoperative pain intensity, and thus may be used to predict severe postoperative pain. Self-rating of pain sensitivity using the “Pain Sensitivity Questionnaire (PSQ)” may be an adjunct to these measures.

Methods: We tested the predictive ability of the PSQ as well as experimental parameters of pain sensitivity and other known risk factors for acute pain in 198 patients scheduled for breast cancer surgery. A multivariable logistic regression model was created for the binary outcome “maximum pain >3 during the first 24 hours postoperatively.”

Results: The PSQ score proved to be an independent risk factor for at least moderate pain during the first 24 hours after surgery. Univariate analysis yielded in addition younger age, type of surgery (mastectomy vs. breast-conserving surgery), axillary dissection, expected pain, and the anxiety scores of the State-Trait Anxiety Inventory, as well as the score of the Beck Depression Inventory as risk factors. Of the experimental parameters of pain sensitivity, only the pain intensity elicited by a hot water bath was a predictor of at least moderate postoperative pain. Multivariable analysis led to a parsimonious model including only PSQ, the State-Trait Anxiety Inventory state score with a cutoff of ≥30, age with a cutoff of <55, mastectomy (vs. breast-conserving surgery), and axillary dissection.

Discussion: Results need to be validated in a larger cohort and for other types of surgery, but use of the simple PSQ may help to identify patients at risk of intense acute postoperative pain.

Departments of *Anesthesiology

Health and Community Medicine, CRC & Division of Clinical Epidemiology, Geneva University Hospitals and University of Geneva, Geneva

Département Médical, Hôpital du Jura, Delémont, Switzerland

Funded solely by the “fonds de service” of the Department of Anesthesiology, Pharmacology, and Intensive Care Medicine of the Geneva University Hospitals, Geneva, Switzerland. The authors declare no conflict of interest.

Reprints: Benno Rehberg, MD, Service d’Anesthésiologie, Hôpitaux Universitaires de Genève Rue Gabrielle-Perret-Gentil 4 CH-1211 Genève 14, Switzerland (e-mail:

Received November 18, 2015

Received in revised form March 31, 2016

Accepted March 9, 2016

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