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Greater pain catastrophizing linked with opioid use after ambulatory hand surgery
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BOSTON — Patients undergoing ambulatory hand surgery who had higher pain catastrophizing scores experienced increased postoperative opioid use and medication refill rates, as well as greater levels of pain, according to results presented at the American Society for Surgery of the Hand Annual Meeting, here.
Preoperatively, Hayley A. Sacks, BA, and colleagues at Hospital for Special Surgery had 85 patients scheduled to undergo ambulatory hand surgery for arthroscopy, trigger finger and carpal tunnel releases, and other procedures complete the pain catastrophizing scale (PCS) and 15-item Mindful Attention Awareness Scale (MAAS). Patients filled out a pain medication diary for pill counts and pain levels on the first day of surgery. Researchers reviewed the diary entries and the patients’ need for refills on postoperative days 3, 8 and 15.
Patients had a median PCS score of eight and a median MAAS score of five, Sacks said.
“The median opioid pills consumed was three, which was quite low, although it did range from 0 to 49,” she said.
Overall, 7% of patients required refills, 66% of patients reported taking any opioid medication and the average postoperative pain level at week 1 was three, according to Sacks.
“Using correlation coefficients, we found that patients with higher pain catastrophizing scores consumed [a] significantly [greater] number of opioids,” Sacks said.
In addition, there was a significant association between higher PCS scores and average week 1 pain, she said, noting patients who required prescription refills and patients who took any opioids had higher PCS scores than patients who did not require refills or did not take opioids, respectively.
“Mindfulness scale scores were not significantly correlated with number of pills consumed, need for refills or opioid use, although patients with higher mindfulness reported less postop pain,” Sacks said. – by Casey Tingle
Reference:
Sacks HA, et al. Paper 04. Presented at: American Society for Surgery of the Hand Annual Meeting; September 13-15, 2018; Boston.
Disclosure: The study was supported by an AFSH Residents and Fellows Fast Track Grant.