Parameters identified on multivariate analysis:
(1) age in years
(2) cold-pressor induced pain, associated with holding the non-dominant hand in a water and crushed ice mixture for up to 4 minutes.
(3) level of preoperative neuroticism (based on a 22-item neuroticism questionnaire described in Appendix A)
|
Parameter
|
Finding
|
Points
|
|
age in years
|
younger
|
1
|
|
|
older
|
0
|
|
sensitivity to cold-pressor induced pain
|
no
|
0
|
|
|
yes
|
1
|
|
preoperative neuroticism
|
none to low
|
0
|
|
|
moderate to high
|
1
|
where:
• Young age was not defined. The mean age was 41 (over a range 20 to 79). An age < 40 was used in the spreadsheet but may need to adjusted downwards.
• Sensitivity to the cold pressor test was withdrawal of the hand from the ice slurry before the 4 minute period because of pain.
number of risk factors for early pain =
= SUM(points for the risk factors)
Interpretation:
• minimum number of risk score: 0
• maximum number of risk factors: 3
• The risk of early postoperative pain increases with the number of risk factors present.
• Incisional pain tended to dominate over other forms of pain (visceral, shoulder).
