Pain Catastrophizing Scale as a Predictor for Acute Postoperative Pain Following Video-Assisted Thoracoscopic Surgery Lobectomy

This prospective observational study examined the association between Pain Catastrophizing Scale (PCS) scores and postoperative pain in 100 patients undergoing multiportal video-assisted thoracic surgery (VATS) lobectomy. The PCS is a 13-item self-report tool measuring catastrophic thinking related to pain, including rumination, magnification, and helplessness, with scores ranging from 0 to 52. Patients completed the PCS preoperatively, and pain was assessed twice daily for two days postoperatively during rest, coughing, use of a positive expiratory pressure (PEP) device, and a five-meter walk test. Those with high PCS scores (greater than or equal to 20) reported significantly greater pain during coughing and walking and were more likely to experience moderate-to-severe pain. Linear regression confirmed PCS as a strong predictor of increased pain. All patients received standardized ERAS protocol pain management. Incorporating PCS may enable more targeted analgesia for breakthrough pain, moving beyond opioid dose titration alone.