The Influence Of Preoperative Depression State To Postoperative Pain Score

Objective:To explore the correlation of preoperative depression and postoperative pain in patients with abdominal surgery by evaluating the degree of postoperative pain and preoperative depression.Methods:The degree of depression of patients with abdominal surgery were assessed before operative with Self-rating depression scale, and the patients with abdominal surgery were divided into the depression group (n=60) and control group (n= 20). Patient controlled intravenous analgesia (PCIA) were given in theses two groups after operation. The degree of postoperative pain were evaluated with the visual analog scale score (VAS) or simplified MeGill pain questionnaire (SF-MPQ) in 12h,24h or 48h after operation, respectively.Furthermore, the amount of pressing were calculated. It was analysed for the variation trend and correlation.of degree of preoperative depression and postoperative pain in these patients.Results:(1) There was no statistical difference between depression group and the control group on the general data analysis.(2) The SDS score of the control group was 46.0±6.6 while that of the depression group was 66.0±7.3, which was significantly different between the two groups (P<0.01). The SDS score was 24 in patients with the mild depression,23 in patients with the moderate depression,13 in patients with the severe depression, respectively.(3) Compared with the control group, the VAS score of the depression group was significantly increased in 12h or 24h after operation, respectively, (12h:8.2±2.4 vs 7.3±2.1;24h:6.7±1.9 vs 5.3±1.5, P<0.05).(4) The SF-MPQ score of the depression group was increased more than that of the control group, (10.4±3.7 vs 7.3±2.2,8.9±2.9 vs 6.9±1.5, P<0.05).But for the comparison in the VAS scores or the SF-MPQ score on postoperative 48h between these two groups, there was no significant difference.(5) The PICA pressing number in the depression group for the period of postoperative 24h was 15.4±3.3,which was significantly more than that in the control group(6.7±2.24).(6) For the pain scores in depressive patients on 12h or 24h after operation, there was positive correlation with the depressive degree before operation (VAS: r=0.826,0.746, P<0.05; SF-MPQ:r=0.878,0.759, P<0.05). In contrast, there was no correlation between them on 48h after operation.Conclusion:The postoperative early pain scores in depressive patients with abdominal surgery has positive correlation with the depressive degree before operation.