Situational but not dispositional pain catastrophizing correlates with early postoperative pain in pain-free patients before surgery

Pain catastrophizing may be assessed as a dispositional measure using a previous painful experience as a reference or as a situational measure using an actual ongoing pain as a reference. The latter has shown more robust correlations with pain-related outcomes; the relative influence of dispositional and situational pain catastrophizing remains unknown in relation to populations with no pain prior to surgery. Forty-two consecutive patients undergoing corrective surgery for funnel chest were asked to complete the Pain Catastrophizing Scale with reference to (1) a previous painful experience (dispositional pain catastrophizing); (2) experimental pain during a two-minute cold pressor test (situational-experimental pain catastrophizing); and (3) clinical pain three days after surgery (situational-clinical pain catastrophizing) to investigate whether these measures predicted immediate pain intensity and unpleasantness in the early postoperative period. Thirty-four patients were available for analyses. Dispositional pain catastrophizing was unrelated to situational-experimental and situational-clinical pain catastrophizing and to postoperative pain and unpleasantness (p>0.05). In contrast, the two situation-specific pain catastrophizing measures were strongly associated (ρ=0.59, p=0.0002). In analyses adjusted for preoperative anxiety, depression, and cold pressor pain sensitivity, situational-experimental and situational-clinical pain catastrophizing correlated with postoperative movement-evoked pain (b=1.36, p=0.01 and b=1.24, p=0.02, respectively) and unpleasantness (b=1.32, p=0.01 and b=1.36, p=0.01, respectively).

PERSPECTIVE: Pain catastrophizing should be captured in relation to specific painful events in otherwise healthy patients. Future studies might benefit from assessing situational pain catastrophizing to identify patients at risk for increased postoperative pain to optimize stratified pain treatment.