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

• Shin Y
• Park TW
• Kim H
• Shim Dj
• Lee H
• Kim JD
• Kang D

• KMID: 2500978
• DOI: http://doi.org/10.17085/apm.2020.15.2.241

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

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

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  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]).

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  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]).

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  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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