Relationship Perception of Pain in the Perioperative Period, and Psychological Characteristics of the Patient

Abstract

Modern researches show that preoperative anxiety, depression, nervousness, are connected to the high-intensive increase of postoperative pain and might have a negative effect on the result of a surgery. However, there's a lack of situations showing the connection of the pain intensity with a patient's personal characteristics, his “own view of the illness”, attitude to treatment, although clinically such connection is traced. This fact stipulated the purpose of the research: to study the interrelation of the features of perception of pain during preoperative period with characteristics of psychic condition and the attitude to treatment of patients, who were operated on thyroid and pelvic organs. The patients were divided in two groups depending on type of surgery used. During the preoperative period, the patients were checked for pain sensitivity twice: after a finger prick and a venepuncture. Also, they were checked four times during the postoperative period, right after the awakening, 1 hour after the awakening, 3 hours after the awakening and 24 hours after the operation. Visual-analog scale was used for examining the patients. Psychic characteristics were studied using the “Integrative test of anxiety”, “Survey of neurotic disorders” and a questionnaire “Types of attitudes to diseases”. Each patient was estimated in total of 70 indexes, including 54 psychic ones. It was identified that the relationship between the intensity of pain feeling in postoperative wound and psychic characteristics of patients was far more expressed in longer time periods after the operation (3 hours and, especially, in 24 hours after the operation) compared to short periods after the operation. During all time periods in both clinical groups most connections with pain intensity have emotional and affective characteristics of a person and psychic conditions examined in preoperative period. One type out of twelve studied cannot be said as the most significantly prognostic. Different types of attitudes are highly statistically important in correlation with the intensity of pain after 3 hours of the operation. Most importantly, it is related to patients who had an operation on thyroid. More connections between psychic characteristics and pain sensitivity were found after having a venepuncture compared to similar connections after picking blood from a patient's finger.