Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.07.007
Brazilian Journal of Anesthesiology
Original Investigation

Associations between postoperative analgesic consumption and distress tolerance, anxiety, depression, and pain catastrophizing: a prospective observational study

Associações entre consumo de analgésicos no pós-operatório e tolerância ao sofrimento, ansiedade, depressão e catastrofização da dor: um estudo observacional prospectivo

Hakan Tapar, Zeki Özsoy, Mehtap Gürler Balta, Fatih Daşıran, Gülşen Genç Tapar, Tuğba Karaman

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Abstract

Background
Patients’ postoperative treatment might be affected by their psychological state. The study aimed to evaluate the effects of anxiety, coping ability (stress tolerance), depression, and pain catastrophizing on analgesic consumption in patients scheduled for sleeve gastrectomy.

Methods
This prospective observational study consisted of 72 patients. The Distress Tolerance Scale (DTS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Pain Catastrophizing Scale (PCS) were completed in the preoperative period. In the postoperative period, pain intensity, as measured with the Visual Analogue Scale (VAS), and morphine consumption (mg) were evaluated after 2, 6, 8, and 24 hours. Total morphine consumption was recorded.

Results
The results revealed a strong negative correlation between distress tolerance and postoperative total morphine consumption (r = −0.702, p < 0.001). There was a strong positive correlation between total morphine consumption and pain catastrophizing (r = 0.801, p < 0.001). A moderate positive correlation was observed between total morphine consumption and anxiety and between total morphine consumption and depression (r = 0.511, p < 0.001; r = 0.556, p < 0.001, respectively). Linear regression revealed that distress tolerance, anxiety, depression, and pain catastrophizing are predictors of postoperative morphine consumption (β = 0.597, p < 0.001; β = 0.207, p = 0.036; β = 0.140, p = 0.208; β = 0.624, p < 0.001, respectively).

Conclusions
Distress tolerance, anxiety, depression, and pain catastrophizing can be predictive of postoperative analgesic consumption. In the estimation of postoperative analgesic consumption, distress tolerance, as well as anxiety, depression, and pain catastrophizing, were found to be important predictors.

Keywords

Anxiety;  Depression;  Distress tolerance;  Pain catastrophizing;  Pain;  Analgesia

Resumo

Introdução: O tratamento pós-operatório dos pacientes pode ser afetado pelo seu estado psicológico. O estudo teve como objetivo avaliar os efeitos da ansiedade, capacidade de enfrentamento (tolerância ao estresse), depressão e catastrofização da dor no consumo de analgésicos em pacientes agendados para gastrectomia vertical. Métodos: Este estudo observacional prospectivo foi composto por 72 pacientes. A Escala de Tolerância ao Sofrimento (DTS), o Inventário de Ansiedade de Beck (BAI), o Inventário de Depressão de Beck (BDI) e a Escala de Catastrofização da Dor (PCS) foram preenchidos no pré- -operatório. No pós-operatório, a intensidade da dor, medida com a Escala Visual Analógica (EVA), e o consumo de morfina (mg) foram avaliados após 2, 6, 8 e 24 horas. O consumo total de morfina foi registrado. Resultados: Os resultados revelaram uma forte correlação negativa entre tolerância ao sofrimento e consumo total de morfina no pós-operatório (r = -0,702, p < 0,001). Houve uma forte correlação positiva entre o consumo total de morfina e a catastrofização da dor (r = 0,801, p < 0,001). Uma correlação positiva moderada foi observada entre o consumo total de morfina e ansiedade e entre o consumo total de morfina e depressão (r = 0,511, p < 0,001; r = 0,556, p < 0,001, respectivamente). A regressão linear revelou que tolerância ao sofrimento, ansiedade, depressão e catastrofização da dor são preditores de consumo de morfina pós-operatório (β = 0,597, p < 0,001; β = 0,207, p = 0,036; β = 0,140, p = 0,208; β = 0,624, p < 0,001, respectivamente). Conclusões: Tolerância ao estresse, ansiedade, depressão e catastrofização da dor podem ser preditivos do consumo de analgésicos no pós-operatório. Na estimativa do consumo de analgésicos no pós-operatório, a tolerância ao sofrimento, assim como a ansiedade, a depressão e a catastrofização da dor foram consideradas importantes preditores.

Palavras-chave

Ansiedade; Depressão; Tolerância ao sofrimento; Catastrofização da dor; Dor; Analgesia

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