The Brief Measure of Emotional Preoperative Stress (B-MEPS) as a new predictive tool for postoperative pain: A prospective observational cohort study

Abstract

Background Preoperative patients' vulnerabilities such as physical, social, and psychological are implicated in postoperative pain variability. Nevertheless, it is a challenge to analyze a patient's psychological profile in the preoperative period in a practical and consistent way. Thus, we sought to identify if high preoperative emotional stress, evaluated by the Brief Measure of Emotional Preoperative Stress (B-MEPS) scale is associated with higher postoperative pain levels and poor rehabilitation in patients submitted to intermediate or major surgery. Moreover, the possible neurobiological or neurophysiological mechanisms implicated in high preoperative emotional stress, evaluated through preoperative quantitative sensory pain tests and serum biomarkers BDNF and S100B were investigated. Methods We conducted a prospective, observational, cohort study of ASA 2 and 3 adult patients undergoing major urologic, gynecologic, proctologic and orthopedic surgeries from March 2017 to March 2018. B-MEPS and Central Sensitivity Inventory were evaluated preoperatively, followed by a sequence of experimental pain tests and serum biomarkers collection. Postoperative evaluation carried out within the first 48 hours after surgery comprehended pain at rest and movement-evoked pain, and the consumption of morphine. Quality-of-Recovery was also evaluated in the 3rd postoperative day. Results 23 (15%) out of 150 patients included in the study presented high emotional preoperative stress. Variables significantly related to preoperative stress were: previous psychiatric

Perioperative Pain Management and Opioid Stewardship: A Practical Guide

“…Prospective identification of these challenges, including the application of standardized cognitive and psychosocial assessments, can allow for appropriate preoperative referral, patient optimization, and future study of risk mitigation strategies [15,18,52,75,78,80,88]. To this end, various predictive tools for postoperative pain are being explored [88][89][90][91]. Patient-centered education and expectation management during the pre-admission phase of care are effective strategies for improving postoperative pain control, limiting postoperative opioid use, decreasing complications and readmissions, and increasing postoperative function and quality of life [15,18,[92][93][94][95][96][97][98].…”

“…Validated health literacy assessments have been applied to surgical populations [ 83 , 84 , 85 , 86 , 87 ]. Prospective identification of these challenges, including the application of standardized cognitive and psychosocial assessments, can allow for appropriate preoperative referral, patient optimization, and future study of risk mitigation strategies [ 15 , 18 , 52 , 75 , 78 , 80 , 88 ]. To this end, various predictive tools for postoperative pain are being explored [ 88 , 89 , 90 , 91 ].…”

Do “central sensitization” questionnaires reflect measures of nociceptive sensitization or psychological constructs? A systematic review and meta-analyses

“…The questionnaire used to assess pain catastrophising was the pain catastrophising scale (PCS) [94]. The questionnaires used to assess stress were the DASS-21 [67], the Perceived Stress Scale (PSS) [68], 4DSQ [125]and the Brief Measure of Emotional Preoperative Stress (B-MEPS) [138]. The questionnaires used to assess sleep were the Medical Outcomes Study Sleep Scale (MOS) [3], the Basic Scale of Insomnia Complaints and Quality of Sleep (BaSIQs) [2], and the Insomnia Severity Index (ISI) [87].…”

The impact of multimodal analgesia based enhanced recovery protocol on quality of recovery after laparoscopic gynecological surgery: a randomized controlled trial

“…Additionally, it is important to note that, not only nociceptive stimulus from tissue trauma, but also other factors such as socio-culture and individual characteristics may affect subjective pain perception. Wolmeister and colleagues [ 26 ] demonstrated that individuals with elevated preoperative emotional stress present higher postoperative pain levels. Person and colleagues [ 27 ] suggested that women with high stress-coping abilities have a better outcome in general well-being than women with low stress-coping capacity.…”