Association Between Pain Catastrophizing and PONV in Laparoscopic Cholecystectomy Patients

The Relationship Between Pain Catastrophizing Scale and Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy

This study aims to explore whether patients' tendency to exaggerate or focus on pain (pain catastrophizing) is related to experiencing nausea and vomiting after surgery. The study will include patients undergoing laparoscopic cholecystectomy. Before surgery, patients will answer questions measuring pain catastrophizing and rate their pain during intravenous cannulation. Nausea and vomiting will be assessed at various times during the first 24 hours after surgery. The results may help better understand how psychological factors affect postoperative symptoms.

This study is designed as a prospective, cross-sectional, and observational study. The Pain Catastrophizing Scale (PCS) is a well-established self-report instrument developed to assess catastrophic thinking related to pain. It evaluates how individuals perceive and respond to pain, focusing on tendencies such as rumination, magnification, and feelings of helplessness. Evidence suggests that PCS is a strong predictor of pain intensity, independent of anxiety levels. In this study, the validated Turkish version of the Pain Catastrophizing Scale will be used.

Postoperative nausea, vomiting, and retching are common adverse events that can complicate recovery from anesthesia. Patients often perceive these symptoms as more distressing than postoperative pain, and they represent important outcomes affecting patient satisfaction and recovery.

The present study aims to investigate the relationship between pain perception during intravenous (IV) cannulation, pain catastrophizing levels, and postoperative nausea and vomiting. By evaluating numeric pain scores during IV access alongside PCS scores, this study seeks to explore whether preoperative pain perception and psychological factors are associated with the frequency of postoperative nausea and vomiting.

The findings of this study are expected to contribute to a better understanding of the role of psychological factors in postoperative symptoms and may help improve anesthesia practices by supporting more individualized, patient-centered perioperative care.

Inclusion Criteria:

• Adult patients aged 18-65 years
• American Society of Anesthesiologists (ASA) physical status I-II-III
• Scheduled for elective laparoscopic cholecystectomy
• Able to provide informed consent

Exclusion Criteria:

• Age <18 or >65 years
• Emergency surgery
• ASA physical status > III
• Pregnancy
• Chronic opioid use
• Known drug allergy
• Psychiatric disorders
• Neurological diseases (central or peripheral neuropathy)
• History of cerebrovascular disease (stroke)
• Chronic renal disease
• Chronic pulmonary disease
• Patients who refuse to participate