ArticlePreoperative Distress Factors Predicting Postoperative Pain in Adolescents Undergoing Surgery: A Preliminary Study
Section snippets
Methods
Ethics approval was obtained prior to the beginning of the study from the Research Ethics Board of McGill University. Written informed patient assent and parental consent were obtained prior to the beginning of the study. A description of the experimental design is provided in Table 1.
Study Population
A total of 58 adolescents diagnosed with AIS were enrolled in the study. Thirty-eight female and five male patients scheduled to undergo spinal fusion surgery were recruited for the study arm. All surgical patients underwent a classic posterior spinal fusion either across the thoracic and/or the lumbar spine. The control group consisted of 13 female and 2 male patients with AIS who were followed up in the clinic for scoliosis but were not scheduled for surgery.
Comparison of Preoperative (Baseline) Variables Between Groups
Baseline psychological assessment
Discussion
The goals of this preliminary study were to (a) understand the relationship between psychological and physiological dimensions of distress and self-reported pain intensity before a surgical procedure and (b) to assess the predictive roles of these variables on postoperative pain intensity. Compared with control subjects not scheduled for surgery, the anticipation of upcoming surgery was associated with significantly higher self-reported state anxiety. No other differences were observed between
Conclusion
The quest to find predictors of which patients are at greater risk of having chronic postsurgical pain is of high relevance in pediatrics. In adolescent patients scheduled for spine surgery, salivary cortisol was significantly increased just before entering the operating room but was not associated with the baseline state or trait anxiety of patients or with postoperative pain at any time point. Preoperative pain intensity was the only variable measured that was associated with postoperative
Catherine E. Ferland, Postdoctoral Fellow, Shriners Hospital for Children–Canada; Department of Surgery, McGill University; McGill Scoliosis & Spine Research Group; Alan Edwards Centre for Research on Pain, McGill University; and Faculty of Dentistry, McGill University, Montreal, Canada.
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2020, Journal of Pediatric NursingCitation Excerpt :Studies on adult patients based on TUS also reported anxiety as a psychological predictor of POP (hauglum Sh., 2015; Ip et al., 2009). Contrary to our findings, some studies reported no significant relationship between anxiety and POP among children and attributed it to factors such as small sample size and inappropriate time for POP measurement (Ferland et al., 2016). Finally, study findings showed coping strategies as the other psychological predictor of POP among children.
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Catherine E. Ferland, Postdoctoral Fellow, Shriners Hospital for Children–Canada; Department of Surgery, McGill University; McGill Scoliosis & Spine Research Group; Alan Edwards Centre for Research on Pain, McGill University; and Faculty of Dentistry, McGill University, Montreal, Canada.
Neil Saran, Orthopedic Surgeon, Shriners Hospital for Children–Canada; Department of Surgery, McGill University; McGill Scoliosis & Spine Research Group; and McGill University Health Centre, Montreal, Canada.
Teresa Valois, Anesthesiologist, McGill University Health Centre, Montreal, Canada.
Sheila Bote, Research Nurse, Shriners Hospital for Children–Canada; and McGill Scoliosis & Spine Research Group, Montreal, Canada.
Jill M. Chorney, Child Psychologist, IWK Health Centre, Halifax, Canada.
Laura S. Stone, Associate Professor, McGill Scoliosis & Spine Research Group; Alan Edwards Centre for Research on Pain, McGill University; Department of Anesthesia, McGill University; Department of Pharmacology and Therapeutics, McGill University; and Faculty of Dentistry, McGill University, Montreal, Canada.
Jean A. Ouellet, Orthopedic Surgeon, Shriners Hospital for Children–Canada; Department of Surgery, McGill University; McGill Scoliosis & Spine Research Group; Alan Edwards Centre for Research on Pain, McGill University; and McGill University Health Centre, Montreal, Canada.
Financial support provided by the Louise and Alan Edwards Foundation (to JAO, CEF and LSS), the Canadian Institutes of Health Research (MOP126046 to LSS and CEF, MOP102586 to LSS, and MOP192333 to JMC and JAO), and the Shriners Hospitals (CAN84292 to JAO and CEF). CEF received fellowships from the CIHR-NeuroInflammation training program, the Quebec Network for Oral and Bone Health, les Fonds de Recherche du Québec-Santé, and the Shriners Hospitals for Children.
JAO has received lecture fees and funding from DePuy Synthes, Zuchwil, Switzerland. None of the other authors has conflicts of interest to report.