Does the pain sensitivity questionnaire correlate with tourniquet pain in patients undergoing ankle surgery?

Qiuyue Fu; Mingming Han; Yuyang Mu; Lina Hao; Liang Lu; Xiang Huang; Juan Li; Fang Kang

doi:10.3389/fsurg.2023.1102319

Does the pain sensitivity questionnaire correlate with tourniquet pain in patients undergoing ankle surgery?

Front Surg. 2023 Feb 27:10:1102319. doi: 10.3389/fsurg.2023.1102319. eCollection 2023.

Authors

Qiuyue Fu¹, Mingming Han¹, Yuyang Mu¹, Lina Hao¹, Liang Lu², Xiang Huang¹, Juan Li¹, Fang Kang¹

Affiliations

¹ Department of Anesthesiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China.
² Department of Hand and Foot Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China.

Abstract

Background: Tourniquet pain is the most prominent problem in ankle surgery, and there is no proper method to predict it. It was reported that pain sensitivity questionnaires could evaluate the pain sensitivity of subjects. Its potential to predict tourniquet pain in ankle surgery is constructive and meaningful.

Methods: One hundred and twenty patients undergoing ankle surgery were included in this study. The pain sensitivity questionnaire (PSQ) and self-rating anxiety scale (SAS) were completed before the operation. The methods included an ultrasound-guided popliteal sciatic, a femoral nerve block, and a proximal thigh tourniquet. The pressure of the tourniquet was set according to the systolic blood pressure (SBP + 100 mmHg). A visual analogue scale (VAS) was used to assess the tourniquet pain. Also, the onset time of tourniquet pain ≥4 VAS units was recorded.

Results: The PSQ-total and PSQ-minor scores were significantly correlated with the onset time when the tourniquet pain ≥4 VAS units (r = -0.763, r = -0.731, P < 0.001). The PSQ-total score <6.5 group gave significantly lower ratings for items 3, 4, 14, and 16 in the PSQ survey compared to the PSQ-total score ≥6.5 group (P < 0.05). Patients with high pain sensitivity have a higher need for analgesic drugs (P < 0.001). PSQ-total score ≥6.5 (OR = 185.8, 95% CI = 39.8-1,437.6, P < 0.001), sex (male, OR = 0.11, 95% CI = 0.018-0.488, P < 0.05), and age (OR = 0.92, 95% CI = 0.842-0.995, P < 0.05) were risk factors for reporting a tourniquet pain ≥4 VAS units within 30 min.

Conclusion: The PSQ score is found to be correlated with intraoperative tourniquet pain. In addition, sex and age also affect the time of having intraoperative tourniquet pain.

Keywords: ankle surgery; nerve block; pain; pain sensitivity questionnaire; tourniquet.

Grants and funding

This study was funded by the Natural Science Foundation of Anhui Province (grant no. 2108085MH323) and Wujieping Medical Foundation (grant no. 320.6750.2021-03-2).