Gender differences on preoperative psychologic factors affecting acute postoperative pain in patients with lumbar spinal disorders

Yuki Watanabe; Takuya Nikaido; Shoji Yabuki; Jumpei Abe; Hideki Suzuki; Keita Shishido; Hirotaka Kobayashi; Rii Yoshida; Kaori Iinuma; Sakiko Nagamine; Yoko Ono; Mari Sato; Naoyuki Oi

doi:10.1016/j.jos.2023.08.019

Gender differences on preoperative psychologic factors affecting acute postoperative pain in patients with lumbar spinal disorders

J Orthop Sci. 2023 Oct 12:S0949-2658(23)00258-0. doi: 10.1016/j.jos.2023.08.019. Online ahead of print.

Authors

Affiliations

¹ Department of Rehabilitation Center, Fukushima Medical University Hospital, Fukushima City, Fukushima, Japan. Electronic address: cervello@fmu.ac.jp.
² Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan.
³ Department of Rehabilitation Center, Fukushima Medical University Hospital, Fukushima City, Fukushima, Japan.
⁴ Department of Rehabilitation Center, Fukushima Medical University Hospital, Fukushima City, Fukushima, Japan; Department of Rehabilitation Medicine, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan.

PMID: 37838597
DOI: 10.1016/j.jos.2023.08.019

Abstract

Background: Psychosexual factors are one of the preoperative factors influencing acute postoperative pain. Because of gender differences in pain, the preoperative factors that influence acute postoperative pain may also differ between males and females. However, there have been no reports on such factors in patients with spinal disorders that focused on gender differences. Therefore, the purpose of this study was to examine the preoperative factors that influence acute postoperative pain, focusing on gender differences.

Methods: The subjects were 75 males and 60 females admitted for surgery for lumbar spinal disorders. Preoperatively, the following were assessed: low back pain using the Numeric Rating Scale (NRS); anxiety and depression using the Japanese version of the Hospital Anxiety and Depression Scale (HADS); catastrophic thinking using the Pain Catastrophizing Scale (PCS); psychiatric problems using the Brief Scale for Psychiatric Problems in Orthopaedic Patients (BS-POP); and neurological assessments. Acute postoperative pain was also assessed using the NRS within 48 h, postoperatively. Based on these data, we analyzed gender differences in preoperative factors affecting acute postoperative pain in patients with lumbar spinal disorders.

Results: Postoperative NRS and preoperative PCS scores were higher in females compared to males. In the males, the coefficient of determination of the multiple regression equation was 0.088, and PCS (β = 0.323, p = 0.015) was extracted as a significant factor. In the females, the coefficient of determination of the multiple regression equation was 0.075, and BS-POP (β = 0.300, p = 0.019) was extracted as a significant factor.

Conclusion: Preoperative factors influencing acute postoperative pain for patients with lumbar spinal disorders vary by gender. It was suggested that males should be screened using PCS. In females, on the other hand, PCS alone is not sufficient for evaluation. It was suggested that evaluation using BS-POP should be considered in addition to PCS.

Keywords: Acute postoperative pain; Brief Scale for Psychiatric Problems in Orthopaedic Patients; Gender; Lumbar spinal disorders; Pain catastrophizing scale; Psychologic factors.