Preoperative Pain Catastrophizing and Its Association With Postoperative Pain After Lower Limb Trauma Surgery
Condition: Pain, Postoperative
MeSH terms: Pain, Postoperative
Study type: Observational

Summary: 
      The Pain Catastrophizing Scale (PCS) is a psychometric tool to identify PC. A positive
      correlation between PCS scores and various pain outcomes has been reported in acute and
      chronic pain settings. Preoperative catastrophizing is associated with an increased intensity
      of postoperative pain and more analgesic consumption. Likewise, a recent meta-analysis
      revealed that PC is a strong predictor of persistent postsurgical pain. The Nepali version of
      PCS has been validated recently in patients with chronic pain. However, it has not been used
      in patients with acute pain. Therefore, our aim is to assess the relationship between
      preoperative Nepali PCS (N-PCS) scores and postoperative pain intensity and total opioid
      consumption in patients with musculoskeletal trauma planned for surgery.
    

Detailed description: 
      After approval from Institute Review Committee, we will assess eligibility of patients
      admitted in-patient-unit of orthopaedic ward planned for lower limb trauma surgery under
      spinal anesthesia. Recruited patients will be counseled and informed about the study and
      information sheet and consent form provided. Will obtain consent from the participant.
      patients will be asked to complete N- PCS questionnaire preoperatively a night before surgery
      in patient unit. On arrival to the operating room, standard monitoring will be applied. All
      the patients will receive spinal anaesthesia with 2.6 ml of hyperbaric bupivacaine (0.5%) and
      fentanyl 20 µg. NRS scale will be used to assess the intensity of their pain postoperatively
      on arrival to Post-anesthesia care unit, at 2, 4, 6, 12 h and 24 h after the end of surgery.
      One gram paracetamol IV and Ketorolac 30 mg IV will be given at the end of surgery and
      continued at 6 and 8 h intervals postoperatively. If the Numeric rating scale (NRS) for pain
      is > 3 at rest, tramadol 50 mg IV bolus administered, and repeated at 10 min intervals until
      NRS was ≤ 3 for the first 24 h. Patients will be asked to rate their worst or maximum pain
      intensity during the first 24 hours after surgery, on an 11-point numerical rating scale.
      Socio-demographic variables (age, BMI, ethnicity, gender, socio-economic status, occupation
      and education), preoperative anxiety of the participant will be recorded.
    

Intervention name(s): Pre-operative Nepali version of pain catastrophizing scale (PCS) questionnaire
Intervention type(s): Other
Intervention description(s): Patients will be asked to complete the scores based Nepali version of pain catastrophizing scale (PCS) questionnaire preoperatively
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Adult patients with lower limb musculo-skeletal trauma admitted in the orthopaedic unit of
        BPKIHS and planned for elective surgery.