Increased postoperative pain scores in chronic depression patients who take antidepressants

Abstract

Study objective To investigate postoperative pain and current perception thresholds in chronic depression in patients who are treated with antidepressants. Design Prospective, randomized study. Setting Hakodate Watanabe Hospital and Hirosaki National Hospital. Patients 30 patients with major depression and 30 control patients who underwent abdominal surgery with general anesthesia. Interventions Postoperative pain scores via visual analog scale (0-100), current perception thresholds at 5, 250, and 2000 Hz. Measurements and main results: Postoperative pain scores of depressed patients at 8 and 16 hours after the end of anesthesia were 36.2 ± 10.4 and 33.4 ± 8.5, which were significantly higher than 25.2 ± 9.3 and 22.7 ± 8.5 scores of the control patients. Current perception thresholds at 5 Hz, 250 Hz, and 2000 Hz in depressed patients were 38.2 ± 6.7, 76.1 ± 11.3, and 190.8 ± 19.2, respectively. There were no significant differences between the depressed patients and control patients in current perception thresholds at 5 Hz, 250 Hz, and 2000 Hz. We found that visual analog scale scores in depressed patients at 8 and 16 hours after the end of anesthesia correlated with the Hamilton Depression Scale scores before operation. Conclusions The degree of postoperative pain in depressed patients who take antidepressants depends on their depressive state.