Number of subjects | Cognitive–behavioral therapy | No intervention | Unadjusted differences between groups | P value |
40 | 37 | (95% CI)* | ||
Hospital course | ||||
Median duration of surgery (IQR) in minutes | 79 (71 to 94) | 80 (70 to 93) | −1 (−12 to 6) | 0.96 |
Median PACU time (IQR) in minutes | 128 (94 to 171) | 110 (82 to 174) | 18 (−26 to 50) | 0.29 |
Median pain burden (IQR) in score*hours | ||||
0–12 hours | 10.9 (1.9 to 23.0) | 18.8 (7.3 to 31.7) 39.9 (19.8 to 62.2) | −7.9 (−19.2 to 3.5) | 0.10 |
12–24 hours | 25.4 (15.8 to 48.3) | 37.9 (22.1 to 90.0) | −14.5 (−31.7 to 3.2) | 0.22 |
24–48 hours | 58.4 (18.8 to 134.3) | 40.0 (27.1 to 129.5) | 20.4 (−14.6 to 59.9) | 0.38 |
48–72 hours | 34.9 (17.9 to 84.1) | −5.1 (−89.2 to 30.6) | 0.31 | |
Median average pain score (IQR) on a 0–10 scale | 2.9 (1.4 to 3.9) | 3.2 (1.7 to 4.3) | −0.3 (−1.2 to 0.9) | 0.67 |
Acute postoperative pain>4 n (%) | 9 (22) | 10 (27) | −5 (−27 to 17) | 0.79 |
Median opioid analgesia (IQR) in MME | 300 (214 to 401) | 368 (210 to 453) | −68 (−124 to 43) | 0.42 |
Median length of stay (IQR) in hours | 36 (28 to 55) | 29 (26 to 53) | 7 (−3 to 23) | 0.44 |
Three-month follow-up | ||||
Number of subjects | 35 | 33 | ||
Median average pain score (IQR) on a 0–10 scale | ||||
Pain at rest | 1 (0 to 3) | 1 (0 to 2) | 0 (−1 to 2) | 0.43 |
Pain with movement | 2 (1 to 4) | 2 (1 to 4) | 0 (−1 to 1) | 0.91 |
Pain at movement>4 on a 0–10 scale | 9 (26) | 8 (24) | 2 (−22 to 26) | 0.79 |
Median GAD-7 (IQR) (0–21) | 2 (0 to 6) | 2 (0 to 4) | 0 (−2 to 3) | 0.43 |
Median PHQ-9 (IQR) on a 0–27 scale | 4 (2 to 6) | 3 (1 to 6) | 1 (−2 to 3) | 0.24 |
Median WOMAC (IQR) | ||||
Pain on a 0–50 scale | 6 (3 to 13) | 8 (5 to 14) | −2 (−5 to 2) | 0.43 |
Stiffness on a 0–20 scale | 5 (2 to 9) | 5 (3 to 10) | 0 (−3 to 2) | 0.57 |
Physical function on a 0–170 scale | 29 (17 to 50) | 30 (17 to 47) | −1 (−16 to 11) | 0.94 |
Total score on a 0–240 scale | 40 (23 to 73) | 46 (25 to 69) | −6 (−23 to 15) | 0.65 |
Decrease in WOMAC pain subscale>4, n (%) | 29 (83) | 26 (79) | 4 (−18 to 26) | 0.76 |
Median SF-36 (IQR) | ||||
Physical health on a 0–100 scale | 46 (41 to 51) | 43 (38 to 51) | 3 (−5 to 7) | 0.48 |
Mental health on a 0–100 scale | 52 (46 to 58) | 51 (47 to 58) | 1 (−6 to 5) | 0.71 |
Median PCS (IQR) on a 0–52 scale | 3 (0 to 8) | 2 (0 to 7) | 1 (−2 to 5) | 0.47 |
Median CSQ-CAT (IQR) on a 0–36 scale | 2 (0 to 5) | 2 (0 to 3) | 0 (−1 to 2) | 0.55 |
*Difference reported as median difference and 95% CI determined by bootstrapping or difference in percentages with 95% CIs determined using the Clopper-Pearson method.
CSQ-CAT, coping strategies questionnaire-catastrophizing subscale; GAD-7, General Anxiety Disorder 7 question survey; IRQ, first to third quartile; MME, oral morphine equivalents; PACU, postanesthesia recovery unit; PCS, pain catastrophizing scale; PHQ-9, Patient Health Questionnaire 9 question survey; SF-36, Optum SF Short Form Health Survey; WOMAC, Western Ontario and McMaster Universities Arthritis Index.