Anesth Pain Med.  2020 Apr;15(2):241-246. 10.17085/apm.2020.15.2.241.

Correlation between patient health questionnaire-2 and postoperative pain in laparoscopic cholecystectomy

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Kosin University College of Medicine, Busan, Korea

Abstract

Background
Postoperative pain is affected by preoperative depression. If the risk of postoperative pain associated with depression can be predicted preoperatively, anesthesiologists and/or surgeons can better manage it with personalized care. The objective of this study was to determine the efficacy of Patient Health Questionnaire-2 (PHQ-2) depression screening tool as a predictor of postoperative pain.
Methods
A total of 50 patients scheduled for elective laparoscopic cholecystectomy with an American Society of Anesthesiologists grade of 1 or 2 were enrolled. They answered the PHQ-2, which consists of two questions, under the supervision of a researcher on the day before the surgery. The numerical rating scale (NRS) scores were assessed at post-anesthesia care unit (PACU), at 24, and 48 postoperative hours, and the amount of intravenous patient-controlled analgesia (IV-PCA) administered was documented at 24, 48, and 72 postoperative hours. At 72 h, the IV-PCA device was removed and the final dosage was recorded.
Results
The NRS score in PACU was not significantly associated with the PHQ-2 score (correlation coefficients: 0.13 [P = 0.367]). However, the use of analgesics after surgery was higher in patients with PHQ-2 score of 3 or more (correlation coefficients: 0.33 [P = 0.018]).
Conclusions
We observed a correlation between the PHQ-2 score and postoperative pain. Therefore, PHQ-2 could be useful as a screening test for preoperative depression. Particularly, when 3 points were used as the cut-off score, the PHQ-2 score was associated with the dosage of analgesics, and the analgesic demand could be expected to be high with higher PHQ-2 scores.

Keyword

Analgesics; Depression; Postoperative pain

Figure

  • Fig. 1. A study flow chart. IV-PCA: intravenous patient-controlled analgesia.

  • Fig. 2. Relationship between preoperative Patient Health Questionnaire-2 (PHQ-2) score and analgesic consumption on the first day after surgery (correlation coefficient r = 0.68 [P < 0.001]).

  • Fig. 3. Relationship between preoperative Patient Health Questionnaire-2 (PHQ-2) score and analgesic consumption on the second day after surgery (correlation coefficient r = 0.45 [P = 0.010]).

  • Fig. 4. Relationship between preoperative Patient Health Questionnaire-2 (PHQ-2) score and analgesic consumption on the third day after surgery (correlation coefficient r = 0.24 [P = 0.098]).


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