Identifying neuropathic pain and the effects of perioperative psychological intervention in patients with gastric cancer
World J Gastrointest Surg. 2026 Jan 27;18(1):114337. doi: 10.4240/wjgs.v18.i1.114337.
ABSTRACT
BACKGROUND: Patients with gastric cancer (GC) often experience complex pain, including a neuropathic component, which may influence their response to perioperative interventions.
AIM: To identify neuropathic pain (NP) components in patients with GC and evaluate the clinical efficacy of perioperative psychological interventions.
METHODS: The study comprised 100 patients with GC who underwent surgical treatment at Jiujiang No. 1 People's Hospital between April 2022 and April 2025. Using randomized number tables, the participants were allocated into either an observation (n = 50) or control (n = 50) group. The control group received conventional perioperative pain management, while the observation group received additional perioperative psychological interventions. Between-group differences were compared in terms of pain intensity, pain characteristics, anxiety and depression levels, postoperative analgesic consumption, early postoperative recovery, and recovery quality.
RESULTS: On postoperative day 7, both groups exhibited higher Numeric Rating Scale scores for resting and activity pain than that demonstrated on preoperative day 1 (P < 0.05), while Hospital Anxiety and Depression Scale (HADS)-Anxiety and HADS-Depression scores were also lower (P < 0.05). Regarding the primary outcomes, patients in the observation group exhibited lower Numeric Rating Scale scores for resting and activity-related pain and a lower NP-positivity rate than those in the control group (P < 0.05). For the secondary outcomes, patients in the observation group had fewer effective presses for intravenous patient-controlled analgesia, lower morphine equivalents, earlier time to first ambulation, earlier time to first flatus, shorter hospital stays, and higher Quality of Recovery-15 scores compared with the control group (P < 0.05). Moreover, their HADS-Anxiety and HADS-Depression scores were also lower than those in the control group (P < 0.05). Stratified regression analysis revealed significant main effects of group assignment and NP status (P < 0.05), with a significant interaction term between group assignment and NP status (P < 0.05).
CONCLUSION: Effective identification of the NP component in the patients' pain, coupled with perioperative psychological interventions, significantly reduced pain intensity and NP-positivity rates. This approach improved anxiety and depressive symptoms, decreased postoperative analgesic use, accelerated early recovery, and enhanced quality of recovery.
PMID:41695857 | PMC:PMC12898897 | DOI:10.4240/wjgs.v18.i1.114337