Acute postoperative pain after orthognathic surgery can be predicted by the preoperative evaluation of conditioned pain modulation and pain catastrophizing

Keiko Takashima, Yuka Oono, Saori Takagi, Kelun Wang, Lars Arendt-Nielsen, Hikaru Kohase

Research output: Contribution to journalJournal articleResearchpeer-review

6 Citations (Scopus)
56 Downloads (Pure)

Abstract

Introduction: The incidence and severity of chronic postoperative pain (POP) are major clinical challenges, and presurgical conditioned pain modulation (CPM) and pain catastrophizing scale (PCS) assessments have exhibited predictive values for POP. However, whether CPM and PCS assessments are also predictive of acute POP is unknown.

Objectives: We aimed to investigate the relationship between preoperative CPM and PCS and acute POP severity after orthognathic surgery by assessing preoperative CPM and PCS in 43 patients.

Methods: The pressure pain threshold and tonic painful cold-heat pulse stimulation (applied with a pain intensity score of 70 on a visual analogue scale [VAS 0-100]) were used as the test and conditioning stimuli, respectively. The pain area under the postoperative VAS area under the curve (VASAUC) was estimated. The associations between CPM, PCS, and VASAUC were also analyzed.

Results: No patient experienced chronic POP after 1 month. Negative and positive CPM effects (test stimulus threshold was 0% > and 0% ≤ during conditioning stimulation, respectively) were detected in 36 and 7 patients, respectively. For patients with negative CPM effects (CPM responders), multiple regression analysis revealed a prediction formula of log (VASAUC) = (-0.02 × CPM effect) + (0.13 × PCS-magnification) + 5.10 (adjusted R 2 = 0.4578, P = 0.00002, CPM effect; P = 0.002, PCS-magnification; P = 0.0004), indicating that a weaker CPM and higher PCS scores were associated with more acute POP after surgery.

Conclusion: CPM and PCS can predict acute POP after orthognathic surgery.

Original languageEnglish
Article numbere989
JournalPain Reports
Volume7
Issue number2
Pages (from-to)E989
Number of pages10
ISSN2471-2531
DOIs
Publication statusPublished - 5 Mar 2022

Bibliographical note

Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.

Keywords

  • Acute postoperative pain
  • Conditioned pain modulation
  • Orthognathic surgery
  • Pain catastrophizing scale
  • Prediction

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