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Minerva Anestesiologica 2020 Jul 01

DOI: 10.23736/S0375-9393.20.14084-7


language: English

The influence of pain expectation on pain experience after orthopedic surgery: an observational cohort study

Virginie S. NG KUET LEONG 1, Anne KÄSTNER 1, Frank PETZKE 1, Michael PRZEMECK 2, Joachim ERLENWEIN 1

1 Department of Anesthesiology, Pain Clinic, University Hospital, Georg-August-University of Göttingen, Göttingen, Germany; 2 Department of Anesthesiology and Intensive Care, Annastift Orthopedic Hospital of the Medical School Hannover, Hannover, Germany


BACKGROUND: Current literature about the effects of patients’ expectations on relevant outcome measures is still conflicting and incomplete. The aim of this prospective observational study was to assess the influence of expectations and the fulfillment of expectations on post-operative pain intensity and pain relief. Furthermore, clinical characteristics influencing expectations and the fulfillment of expectations were explored.
METHODS: Patients undergoing elective orthopedic surgery were assessed using two standardized self-report questionnaires on the day before surgery and the third post-operative day. 170 patients from 21 to 93 years (average age 64.6, SD 14.0 years; 55% female) were consecutively included.
RESULTS: While expectations of pain intensity did not correlate with pain experience after surgery, the fulfillment of expectations was associated with post-operative pain experience. Patients whose expectations were fulfilled were found to be more satisfied with the overall treatment as compared to those whose expectations were not fulfilled. Higher levels of expected pain were associated with higher fear of surgery and fear of post-operative pain. Pre- operative pain intensity, length of treatment before the surgery, fear of surgery, helplessness and fear of post-operative pain were associated with higher post-operative pain intensity. Lower levels of pre-operative fear of surgery and fear of post-operative pain were found to correlate with the fulfillment of pain relief.
CONCLUSIONS: Our study indicates that post-operative pain and satisfaction with the treatment are associated with the degree of fulfillment of expectations rather than the expected pain itself.

KEY WORDS: Pain management; Post-operative pain; Expectation: Orthopedic surgery

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