Preuentiae Analgesia Is Associated ouitlt Reduced Pain flisabikty 3 Weeks but Not 6 Montbs after Major Gynecologac Surgery by Laparotomy

Backgroudd: Most studles of preemptive or preventive analgesla rrestrlct outcofires to pain and analgesic consumption ln the acute postopcrative p"ttod Tlre potential longer-term effects on tlrese and other domains of functioning have received little emplrical attention. Ttre purpose of this study was to follow up patients who had received general anestlresla plus epiduml fentanyl and lldocaine befole (group 1) or after Group 2) lnclslon or general anesthesia plus a sham epidural (group 3). Metbods: Patients u/er:e corrtacted approximately 3 wecks and 6 rrronths after surgery. A follow-up paln questlonnalre and the McGill Pain Questionnalre were admlnlstered by telephone. The Mental Health Inventory and Pain Disability Index were mailed to patients, completed, and malled back Resuks: One hundred tlrirfy-one of the 141 patients (93vo) were reached 3 weeks after surgery (n = 41, n = 48, and n = 42 lrr groups l, 2, and 3, respectively), atd 1O9 (T7o/o) were reached at 6 months (n = 35, tt = 37, and n = 37 in groups L, 2, anLd 3, respectively). Multivadate analysls of covarlance indicated that that even after cofrtfollfurg for age and presence or absence of preoperatlve patn, Paln DtsablHty Index scorrcs (mean * SD) at the ftrst follow-up were significantly lower ln gloup 1 {17.3 t 12.8) and group 2 (18.1 ! 17.0) compared wlth group 3 Q6.3 ! 18.3). Mcctll Pain Questionnaire and Mental Health Inventory scores did not dlffer slgnlffcantly alnong the groups. There were no slgnlficant dlfferences at tlre 5-month follow-up. Cottchtslon: Tlre short-terrn beneficial effects of prcventlve epidural analgesla translated into less pain di-sability 3 weeks after surgery. Progress in understandlng the pr<rcesses involved in postsurgical recovery and the risk factors for chronic postsurgical paln would be aided by basellne and postsurgical measures of relevant psychologlcal, emotlonal, and physical varlables.