The impact of psychoemotional state on the intensity and nature of pain after hysteroscopic myomectomy.

OBJECTIVE

Aim: To assess the impact of psychoemotional status indicators (state anxiety, trait anxiety, and depression) on the intensity and duration of postoperative pain syndrome in patients after hysteroscopic myomectomy, and to determine their prognostic value for optimising analgesic management under conditions of wartime stress.

PATIENTS AND

METHODS

Materials and

Methods

Ninety reproductive-age patients with submucosal uterine fibroids were examined. Group 1 (n=62) included women living under wartime stress in Ukraine: subgroup 1.1 (n=32) internally displaced persons and subgroup 1.2 (n=30) residents of Kyiv. Group 2 (n=28) comprised Ukrainian women temporarily living abroad who returned to Kyiv for planned surgery. Psychoemotional status was assessed using the Spielberger-Hanin and Beck scales, and pain using the NRS scale. Statistical analysis used nonparametric methods and ROC analysis.

RESULTS

Results

Anxiety levels differed significantly between all groups (p<0.001), highest in internally displaced persons. Subgroups 1.1 and 1.2 had higher NRS pain scores and required the maximum daily dexketoprofen dose (150 mg) compared with group 2. ROC analysis showed state anxiety strongly predicts acute pain intensity (AUC=0.804), while depression predicts pain duration in the outpatient setting (AUC=0.860).

CONCLUSION

Conclusions

Wartime stress significantly modulates pain perception by lowering the pain threshold even during hysteroscopic myomectomy. State anxiety correlates with acute postoperative pain intensity, while depressive states are associated with prolonged pain and the risk of chronification. These findings support personalised analgesia that considers patients' psychoemotional profiles.