ArticlePloS one2017
Age and preoperative pain are major confounders for sex differences in postoperative pain outcome: A prospective database analysis.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.
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Who cites it
40 citing papers in PubMed, 1 synthesis or guideline pooled it, 76 citations in OpenAlex.
- Preoperative predictors of poor acute postoperative pain control: a systematic review and meta-analysis.BMJ open · 2019Pooled it
- Psychophysical predictors of experimental muscle pain intensity following fatiguing calf exercise.PloS one · 2021Trial
- Impact of the Timing of Rocuronium Injection after Propofol Administration on Temporal Summation of Pain in Gynecologic Laparoscopic Surgery: A Prospective and Controlled Study.Pain research & management · 2020Trial
- Sex-related differences in pain following posterior spinal fusion for adolescent idiopathic scoliosis: a retrospective cohort study.Spine deformity · 2026Article
- Drug-specific effects of anxiety on high-dose oxycodone: age as a modifier for oxycodone response.Behavioural pharmacology · 2026Article
- Individualizing Perioperative Analgesia: Patient-Specific Determinants of Postoperative Pain and Opioid-Related Outcomes.Medicina (Kaunas, Lithuania) · 2026Review
- [Postoperative pain and sex/gender-current findings of the past decade].Schmerz (Berlin, Germany) · 2026Article
- Perioperative Anxiety and Stress Cortisol on Postoperative Pain: Pharmacological and Non-Pharmacological Management Strategies.Journal of surgery and research · 2026Article
- Risk Factors for Intolerable Postoperative Pain After Vitreoretinal Surgery Under AoA-Guided General Anesthesia with Intravenous COX-3 Inhibitors: A Post Hoc Analysis.Pharmaceuticals (Basel, Switzerland) · 2025Article
- A DEEP NEURAL NETWORK TWO-PART MODEL AND FEATURE IMPORTANCE TEST FOR SEMI-CONTINUOUS DATA.The annals of applied statistics · 2025Article
- Mapping the importance of each individual element accounted by HOOS and VR-12 on 1-year patient satisfaction after primary total hip arthroplasty: a prospective institutional analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Do Single-Nucleotide Polymorphisms Affect Pain Intensity and Sufentanil Analgesia After Pediatric Scoliosis Correction Surgery?International journal of molecular sciences · 2025Article
- Genome-wide association study on chronic postsurgical pain in the UK Biobank.British journal of anaesthesia · 2025Article
- Attitudes and Experiences of Patients Regarding Gender-Specific Aspects of Pain Management.Pharmacy (Basel, Switzerland) · 2024Article
- Red-Haired People's Altered Responsiveness to Pain, Analgesics, and Hypnotics: Myth or Fact?-A Narrative Review.Journal of personalized medicine · 2024Review
- The Problem of Pain in Rheumatology: Variations in Case Definitions Derived From Chronic Pain Phenotyping Algorithms Using Electronic Health Records.The Journal of rheumatology · 2024Article
- Influence of a chronic beta-blocker therapy on perioperative opioid consumption - a post hoc secondary analysis.BMC anesthesiology · 2024Article
- Pain After Outpatient Surgical Procedures.Deutsches Arzteblatt international · 2024Observational
- Acupuncture Effect on Analgesic Consumption and Cortisol Levels Following Total Knee Arthroplasty: A Randomized Controlled Trial.Medical acupuncture · 2023Article
- The impact of anxiety on postoperative pain following pelvic reconstructive surgery.International urogynecology journal · 2023Observational
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesCurrent literature is in disagreement regarding female sex as a risk factor for pain after surgery. We hypothesized, that sex differences exist but that they are influenced by certain factors. Here, we investigated the influence of sex for different clinically relevant postoperative pain (POP) outcome parameters and evaluated the role of assumed confounders for sex differences.
methodsFrom 1372 screened patients undergoing orthopedic surgery at the university hospital of Muenster between March 2010 and June 2011, 890 patients were included. The validated International Pain Outcomes questionnaire was used to assess the role of sex for several aspects of POP including pain severity, physical and emotional functional interference as well as the patient's perceptions of the care they received on the first day after surgery. Assessed confounders were age, preoperative chronic pain, anesthetic technique employed and surgical procedure. All statistical analyses were performed with SPSS Statistics Software 22.
resultsLinear regression analysis demonstrated that sex was a statistically significant risk factor for "worst pain since surgery". Additionally, significant sex differences in "time spent in severe pain", "feeling anxious due to pain", "feeling helpless due to pain" and "opioid consumption since surgery" could be identified. An univariate general linear model showed that "age" and "preoperative pain" were significant confounders for sex differences. Further descriptive subgroup analysis revealed consistent sex differences for several POP outcome variables especially in patients older than 50 years or patients with preoperative chronic pain. However, sex differences disappeared in younger patients and in patients without preoperative pain. DISCUSSION: Our data confirmed that sex differences exist in pain intensity and frequency, pain interference with feelings and opioid consumption during the first 24 hours postoperatively. However, sex differences were significantly influenced by the factors "age" and "preoperative pain". These findings may in part explain why clinical studies get different results related to sex differences and renders specific awareness in older women and female patients with preoperative chronic pain.
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