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Background and Aims The aim of the study was to analyse the relationship between the preoperative emotional state and the prevalence and intensity of postoperative pain in patients undergoing cardiac surgery, and to explore potential psychological predictors of postoperative pain.

Methods N = 97 patients were examined psychologically before surgery at Dept. of Cardiac Surgery, University Hospital Kralovske Vinohrady, Prague, and on the last day of hospitalization. Pain intensity and five variables of emotional state (Distress, Anxiety, Depression, Anger and Need of Help) were measured using a Visual Analogue Scale (VAS) and Emotional Thermometers.

Results The average age of the patients was M = 65.5, with a predominance of men (75%), the length of hospitalization was M = 8.4 (SD = 6.54) days. Patients underwent aortocoronary bypass (47%), combined procedures (35%) and aortic or mitral valve surgery (18%). A standard medical pain management procedure was used after surgery and during hospitalization. The prevalence of moderate to severe pain (VAS > 5) at the time of discharge was 24.7% (n = 24). For this group before surgery, the most important emotional variable were: anxiety (M = 41.9) and distress (M = 39.8), followed by depression (M = 27.1), anger (M = 11.1) and need for help (M = 12.3). Preoperative anxiety and distress resulted as significant predictive risk factors for moderate to severe postoperative pain (p < 0.05).

Conclusions Psychotherapeutic interventions should be included in pain management in patients with preoperative comorbid emotional problems to prevent persistent postoperative pain.