Application Of Pain Anxiety Scales In Predicting Postoperative Pain In Slow Mohs Micrographic Surgery

Objective:Though slow Mohs Micrographic Surgery(s MMS)is currently acknowledged as the optimal treatment for cutaneous malignancies,pain is constantly present throughout the s MMS treatment.In this prospective study,the author used the Pain Catastrophizing Scale(PCS)and the Pain Anxiety Symptom Scale(PASS)to explore the predictability of these two scales on the intensity of postoperative pain from s MMS.This paper also provides a theoretical foundation for the promotion and application of PCS and PASS clinically and also the timely postoperative pain interventions for s MMS patients.Methods:91 hospitalized patients with basal cell carcinoma(BCC),cutaneous squamous cell carcinoma 2(c SCC),malignant melanoma(MM),and dermatofibrosarcoma of augmentation(DFSP)who underwent s MMS in the Dermatology Department of the First Affiliated Hospital of Xinjiang Medical University from January to October 2022 were selected.Their clinical data including gender,age,ethnicity,educational background,co-existing conditions,and the location,size and the pathological staging of the tumor were all recorded comprehensively and completely.After signing the informed consent,the patients completed the PCS and PASS scales prior to the surgeries.The numeric rating scale(NRS)version 0-10 was used to score the immediate postoperative pain on Day 0 and to record the maximum pain intensity in every 8 hours from Day 0 to postoperative Day 2.Correlation analysis was performed between the postoperative maximum pain scores of s MMS and the preoperative PCS scores and PASS scores respectively,to compare the predictability of the two scales on postoperative pain after s MMS.Results:1.PCS and PASS scores were positively skewed,and the differences in PCS and PASS scores were statistically significant between groups with different educational backgrounds(PCS:P=0.044;PASS:P=0.012).2.93.4%of patients after s MMS suffered the strongest postoperative pain in the first time slot(within 8 hours after surgery).93.4%experienced mild to moderate postoperative pain as the maximum degree,and the pain gradually released(pain went away without intervention or by taking ibuprofen/tramadol).The difference in the highest postoperative NRS score was statistically significant between groups with different tumor sizes(P=0.001).3.A positive correlation was found between the highest postoperative NRS score and PCS score(r_s=0.526,P=0.000)and PASS score(r_s=0.548,P=0.000).Patients were divided into three groups according to PCS score(P=0.000)and PASS score(P=0.000),and the difference between groups of the highest NRS score after s MMS was statistically significant.The PCS score(R~2=0.283)and PASS score(R~2=0.272)were fitted with the highest postoperative NRS score to construct a polynomial model for fitting analysis,respectively,and a quadratic polynomial was selected to fit:The PCS score alone explained 28.3%of the variation in the highest postoperative NRS score,and the PASS score alone explained 27.2%of the variation in the highest postoperative NRS score.Conclusions:s MMS postoperative pain manifests as mild to moderate,and it peaks within the first 8 hours after the surgery.Accurately using PCS and PASS before operation is conducive to predicting the postoperative pain intensity in s MMS,but the predictive efficacy of PCS was slightly lower than that of PASS.