Preoperative Multidimensional Affect and Pain Survey (MAPS) scores predict postcolectomy analgesia requirement.

摘要

OBJECTIVES: One aim of this study was to evaluate the relation of scores on the Multidimensional Affect and Pain Survey (MAPS) that was administered before surgery to postoperative morphine consumption and patient-controlled analgesia. A second aim of the study was to compare the ability of MAPS administered postsurgery with the commonly used Numerical Pain Rating Scale to predict patient-controlled analgesia behavior. DESIGN: The MAPS questionnaire measures pain, suffering, and well-being. It was administered to patients 1 day before and 1 day after left hemicolectomy for colon cancer. The relations of the two scores to postoperative pain control were determined. PATIENTS: Thirty-four patients in the surgical ward of a general hospital admitted for colorectal cancer surgery participated in this study. RESULTS: High preoperative MAPS scores on sensory and emotional words predicted postoperative morphine dosage, dose presses, and lockout presses. Greater morphine consumption was correlated positively with high presurgery MAPS scores in four of the eight "Suffering" subclusters (Depressed Mood, Anger, Anxiety, and Fear). High presurgery MAPS scores in 13 of the 17 "Sensory Qualities" subclusters (e.g., Bothersome, Intense Pain, Pain Extent, Incisive Pressure, Traction/Abrasion) were correlated positively with lockout presses. Neither the postsurgery MAPS nor the postsurgery Numerical Pain Rating Scale predicted patient-controlled analgesia behavior. CONCLUSION: The emotional states and attitudes of the patients toward pain before surgery are important factors in determining patient-controlled analgesia pressing behavior and postoperative demand for analgesics.