The Brief Measure of Emotional Preoperative Stress (B-MEPS) as a new predictive tool for postoperative pain: A prospective observational cohort study
| Autor: | Andressa de Souza, Kahio Cesar Kuntz Nazario, Rafael Poli Caetani, Luciana Paula Cadore Stefani, Anelise Schifino Wolmeister, Stela Maris de Jezus Castro, Carolina Lourenzon Schiavo, Wolnei Caumo |
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| Rok vydání: | 2019 |
| Předmět: |
Estudo observacional
Male Physiology medicine.medical_treatment Emotions Sensory Physiology Cancer Treatment Social Sciences Brief Measure of Emotional Preoperative Stress Anxiety Psychological Distress 0302 clinical medicine 030202 anesthesiology Medicine and Health Sciences Medicine Psychology Prospective Studies Prospective cohort study Dor pós-operatória Pain Postoperative Analgesics Multidisciplinary Rehabilitation Morphine Estudos de coortes Drugs Middle Aged Sensory Systems Surgical Oncology Somatosensory System Oncology Predictive value of tests Preoperative Period Female Psicometria Cohort study Research Article Clinical Oncology medicine.medical_specialty Science Psychological Stress Surgical and Invasive Medical Procedures Pain Psychology S100 Calcium Binding Protein beta Subunit 03 medical and health sciences Predictive Value of Tests Mental Health and Psychiatry Humans Pain Management Aged Pharmacology Estresse business.industry Brain-Derived Neurotrophic Factor Repeated measures design Biology and Life Sciences Pain Sensation Perioperative Opioids Biomarcadores Orthopedic surgery Physical therapy Observational study Clinical Medicine business 030217 neurology & neurosurgery Biomarkers Neuroscience |
| Zdroj: | PLoS ONE Repositório Institucional da UFRGS Universidade Federal do Rio Grande do Sul (UFRGS) instacron:UFRGS PLoS ONE, Vol 15, Iss 1, p e0227441 (2020) Repositório Institucional do Centro Universitário La Salle Universidade La Salle (UNILASALLE) instacron:UNILASALLE |
| ISSN: | 1932-6203 |
| Popis: | Submitted by DSpace Unilasalle (dspace@unilasalle.edu.br) on 2021-09-14T14:48:35Z No. of bitstreams: 1 aswolmeister.etal.pdf: 1110239 bytes, checksum: d5ea52e336d4778e270f41a99b2954a9 (MD5) Made available in DSpace on 2021-09-14T14:48:35Z (GMT). No. of bitstreams: 1 aswolmeister.etal.pdf: 1110239 bytes, checksum: d5ea52e336d4778e270f41a99b2954a9 (MD5) Previous issue date: 2020 Background Preoperative patients’ vulnerabilities such as physical, social, and psychological are implicated in postoperative pain variability. Nevertheless, it is a challenge to analyze a patient's psychological profile in the preoperative period in a practical and consistent way. Thus, we sought to identify if high preoperative emotional stress, evaluated by the Brief Measure of Emotional Preoperative Stress (B-MEPS) scale is associated with higher postoperative pain levels and poor rehabilitation in patients submitted to intermediate or major surgery. Moreover, the possible neurobiological or neurophysiological mechanisms implicated in high preoperative emotional stress, evaluated through preoperative quantitative sensory pain tests and serum biomarkers BDNF and S100B were investigated. Methods We conducted a prospective, observational, cohort study of ASA 2 and 3 adult patients undergoing major urologic, gynecologic, proctologic and orthopedic surgeries from March 2017 to March 2018. B-MEPS and Central Sensitivity Inventory were evaluated preoperatively, followed by a sequence of experimental pain tests and serum biomarkers collection. Postoperative evaluation carried out within the first 48 hours after surgery comprehended pain at rest and movement-evoked pain, and the consumption of morphine. Quality-of-Recovery was also evaluated in the 3rd postoperative day. Results 23 (15%) out of 150 patients included in the study presented high emotional preoperative stress. Variables significantly related to preoperative stress were: previous psychiatric diagnosis and Central Sensitization Inventory result. Mean movement-evoked pain in the first 12 to 48 hours was 95–105% higher than pain at rest. A mixed model for repeated measures showed a sustainable effect of B-MEPS as a movement-evoked pain predictor. Previous pain, cancer surgery, and preoperative pressure pain tolerance were also independent predictors of postoperative pain. Moderate to severe postoperative movement-evoked pain was predictive of poor rehabilitation in 48 hours after surgery. Conclusion We confirmed that a brief screening method of preoperative emotional states could detect individuals prone to experience severe postoperative pain. Specific interventions considering the stress level may be planned in the future to improve perioperative outcomes. |
| Databáze: | OpenAIRE |
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