23. Postoperative Pain in Hand Surgery: Influence of Psychological and Demographic Factors

PURPOSE: The purpose of this study is to investigate how demographic and psychological factors, particularly anxiety and pain catastrophizing, influence postoperative pain perception in hand surgery patients at Mayo Clinic Florida. Given that over 80% of the nearly 100 million surgeries performed annually in the U.S. result in acute postoperative pain, effective pain management remains a significant challenge. Current research suggests that both demographic variables, such as age and gender, and psychological factors play a critical role in determining pain outcomes. This study aims to explore these relationships to improve pain management strategies in the postoperative period. METHODS: In this single-arm clinical trial, patients aged 18 and older undergoing hand surgery at Mayo Clinic Florida were recruited. Preoperatively, patients completed the Pain Catastrophizing Scale (PCS) and the State-Trait Anxiety Inventory (STAI) to assess psychological factors. Postoperatively, patients recorded pain levels using a numerical rating scale (NRS) from 1 to 10 every four hours during awake periods for three days via an iPhone app. Medication use was also logged. Data were analyzed using fixed and mixed effects linear models to assess the relationship between demographic variables, PCS, STAI scores, and pain levels. Pain scores were also dichotomized, and mixed effects logistic regression was used. All statistical tests were two-sided with significance set at p<0.05, analyzed with R4.2.2. RESULTS: Data were collected from 62 patients (37.1% male, 62.9% female) undergoing hand surgery. Participants were mainly White (90.3%), with a median age in the Middle-Aged Adults group. Most had low anxiety levels (80.6% STAI-S, 82.3% STAI-T) and low catastrophizing (61.3% PCS). Postoperative pain scores were generally low, with median scores ranging from 1.0 to 2.0 across the first three days. Mixed effects models showed time as a significant predictor, with higher pain on Day 1 than on Day 0. Logistic regression indicated that time was a key factor for high pain levels, particularly on Day 3. Demographic factors, anxiety, and catastrophizing did not significantly predict pain levels. CONCLUSION: Postoperative pain after hand surgery was generally low, with time being a significant predictor of increased pain on the first and third days. Demographic factors, anxiety, and catastrophizing did not significantly affect pain levels. Pain management should emphasize time-sensitive interventions and ongoing monitoring.