{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T19:52:10Z","timestamp":1778010730644,"version":"3.51.4"},"reference-count":47,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,2,7]],"date-time":"2017-02-07T00:00:00Z","timestamp":1486425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Health Labour Sciences Research","award":["H23-006"],"award-info":[{"award-number":["H23-006"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This prospective study was designed to examine the associations of demographic, clinical, psychological and neuroendocrine factors with acute and chronic post\u2010operative pain following partial mastectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sixty\u2010four female patients scheduled for partial mastectomy were enrolled. Pre\u2010operative anxiety\/depression was assessed, using the Hospital Anxiety and Depression Scale (<jats:styled-content style=\"fixed-case\">HADS<\/jats:styled-content>). Pre\u2010operative 24\u2010h urinary cortisol levels were measured 2\u00a0days before surgery. Post\u2010operative pain was examined using a visual analog scale (<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>) for acute pain on 0\u20132 post\u2010operative day (<jats:styled-content style=\"fixed-case\">POD<\/jats:styled-content>), and a short\u2010form McGill Pain Questionnaire for chronic pain at 6\u00a0months after surgery. In the last 29 subjects, post\u2010operative 24\u2010h urinary cortisol levels were also measured on 0 <jats:styled-content style=\"fixed-case\">POD<\/jats:styled-content> and were subjected to correlation analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Multivariate logistic regression analysis revealed that lower pre\u2010operative cortisol secretion and greater pre\u2010operative anxiety were significantly associated with an increased risk of moderate to severe acute post\u2010operative pain [Odds Ratio (95% Confidence Interval); 0.96 (0.92\u20130.98), and 1.24 (1.04\u20131.54)], and that patients with greater pre\u2010operative anxiety and moderate to severe acute pain were more likely to develop chronic post\u2010operative pain [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>); 1.63 (1.23\u20132.40), and 5.07 (1.30\u201324.6)]. Correlational analysis demonstrated that the post\u2010operative cortisol level was inversely correlated with pre\u2010operative anxiety and the intensity of acute post\u2010operative pain (<jats:italic>r<\/jats:italic>\u00a0=\u00a0\u22120.40, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05, and <jats:italic>r<\/jats:italic>\u00a0=\u00a0\u22120.50, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01), but not with the intensity of chronic pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study confirms that pre\u2010operative anxiety is associated with both acute and chronic post\u2010operative pain after partial mastectomy. It also suggests that lower perioperative cortisol secretion might be associated with greater acute post\u2010operative pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Although the associations between psychological stress\/stress hormone levels and chronic post\u2010operative pain remain to be determined, pre\u2010operative psychological stress and perioperative cortisol levels are correlated with acute post\u2010operative pain.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1014","type":"journal-article","created":{"date-parts":[[2017,2,7]],"date-time":"2017-02-07T12:42:57Z","timestamp":1486471377000},"page":"1144-1153","source":"Crossref","is-referenced-by-count":19,"title":["Psychological and endocrine factors and pain after mastectomy"],"prefix":"10.1002","volume":"21","author":[{"given":"D.","family":"Nishimura","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Keio University School of Medicine Tokyo 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