Phenotyping Battery Patients completed preoperative phenotypingusing validated self-report measures. The primary measure of interest was the 2011 fibromyalgia surveycriteria.The fibromyalgia survey iscomposed of the number of painful body areas assessed by using the MichiganBody Map (0 to 19) and comorbid symptoms such as fatigue, trouble thinking, andheadaches assessed by using the Symptom Severity Index (0 to 12). Hence, thetotal fibromyalgia score ranges from 0 to 31. The measure has demonstrated goodreliability, convergent validity, and discriminant validity. Previous cutpoints have been described to categorize a person as “ fibromyalgia positive”;however, the continuous score was used for the analyses in the current study.Additional phenotyping included pain severity (Brief Pain Inventory; 0 to 10composite score using the mean of the average, least, worst, and pain rightnow; overall body pain and surgical site pain assessed separately); neuropathicpain descriptors (Pain-DETECT),anxiety and depression (Hospital Anxiety andDepression Scale),and catastrophizing (Coping Strategies Questionnaire).Themedication list from the preoperative records was printed and reviewed with thepatient by a research assistant. All medications administered as needed werereviewed in detail to ensure the ability to differentiate the varied patternsof opioid use (e.g., differentiating patient who uses one hydrocodone per weekfrom the person who takes three daily). The average daily opioid consumption was converted to a 24-h oralmorphine equivalent (OME) total. Opioids administered by the anesthesia teambefore and during surgery were also converted to OMEs as a covariate.Demographics, body mass index, and American Society of Anesthesiologists (ASA)physical status score were collected from the electronic medical record(Centricity; General Electric Healthcare, USA). Because all patients receivedgeneral anesthesia, the anesthetic technique was not assessed. The surgical approach was recorded asvaginal, laparoscopic, robotic, or open. |