An examination of the impact of depth of anaesthesia on post-operative pain following wide local excision of breast tissue for breast cancer

Literature Review: Despite Mixed findings previous reviews of the literature have highlighted a predictive relationship between pre-operative psychological variables and post-operative pain (Hinrichs-Rocker, Schulz, Jarvinen & Lefering, 2009). This review examined the research published between 2000 and 2013. Eleven studies were identified and discussed. The review noted evidence that psychological variables specific to aspects of pain, mediated the effect of other psychological variables, which indicate general mood states, on pain. Implications for research and clinical practice were also discussed. Research report: This paper detailed a feasibility study exploring the issues associated with a full scale project analyzing the link between lightness of anaesthesia and post-operative pain (Law, Sleigh, Barnard & MacColl, 2011). A prospective, longitudinal repeated measures design was employed. To control for pre-operative variables the State Trait Anxiety Inventory, state and trait versions (STAI-Y1 and Y2 respectively), The Magill Pain Questionnaire – Short Form (MPQ-SF), the Pain Locus of Control Questionnaire (PLOCQ) and a nonvalidated body image screening question were administered pre-operatively. Depth of anaesthesia was measured intra-operatively using a Bispectral Index Monitor (BIS). Follow up was conducted a 1-2 days, 6 weeks and 3 months post-operatively. At follow up the MPQ-SF, STAI-Y1 and body image screening question were administered. Twelve participants were recruited. A statistically significant effect of lightness of anaesthesia on post-operative pain was not detected due to small sample size. It was concluded that a large scale study would be feasible. Implications for the execution of future research projects are discussed, as well as for clinical practice. Critical Appraisal: The critical appraisal explored personal reflections on the research process. Areas covered included motivations to carry out the research project, the experience of the researcher at various stages of the process and discussion of lessons for future researchers in this area.