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TECHNOLOGY, COMPUTING, AND SIMULATION

The Effect of Pain on Health-Related Quality of Life in the Immediate Postoperative Period

Christopher L. Wu, MD^*, Mohammad Naqibuddin, MBBS, MPH^*, Andrew J. Rowlingson, BA, Steven A. Lietman, MD, Roland M. Jermyn, BA^*, and Lee A. Fleisher, MD^*,

*Department of Anesthesiology and Critical Care Medicine, Joint Appointment in Medicine (Cardiology), Biomedical Information Sciences and Health Policy and Management, and the Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, Maryland

Address correspondence and reprint requests to Christopher L. Wu, MD, The Johns Hopkins Hospital, 600 North Wolfe Street, Carnegie 280, Baltimore, MD 21287. Address email to chwu{at}jhmi.edu

The hypothesis of this study was to determine if the severity of postoperative pain would affect patients’ health-related quality of life (HRQL) in the immediate postoperative period (within 2 wk of surgery). We designed this study as a prospective, nonrandomized observational trial in a tertiary academic care center. Patients undergoing elective total hip or knee replacement surgery were eligible. Patients received a standardized intraoperative general or epidural anesthetic followed by IV patient-controlled analgesia or patient-controlled epidural analgesia. Short Form (SF)-12, visual analog scores for pain at rest and pain with activity, nausea, and itching were assessed on postoperative days 1–5, 7, and 14. The severity of pain correlated with a decrease in both the physical and mental component of the SF-12. The severity of nausea correlated with a decrease in the mental but not physical component of the SF-12. The severity of itching did not correlate with a change in the SF-12. Our findings suggest that an increase in postoperative pain will decrease a patient’s quality of life in the immediate postoperative period; however, several methodologic issues exist when assessing HRQL in the immediate postoperative period.

IMPLICATIONS: Severity of postoperative pain may affect quality of life

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