A systematic review and meta-analysis sought to identify preoperative factors that could predict poor postoperative pain control. Some new links were found, and others that might have been suspected did not show association.
In brief, factors predicting poor postoperative pain control were: younger age, female sex, smoking, history of depressive or anxiety symptoms, sleep difficulties, higher BMI, presence of preoperative pain, and use of preoperative analgesia.
Sleep difficulty and depression showed the strongest association.
Pain catastrophizing, American Society of Anesthesiologists status, chronic pain, marital status, socioeconomic status, education, surgical history, preoperative pressure pain tolerance and orthopedic surgery (vs abdominal surgery) were not associated with increased odds of poor pain control.
Hopefully outcomes can be improved by individualized targeting of pain-predictive factors.