Investigation of the relationship between postoperative pain and both central sensitization severity and sleep quality in patients undergoing breast cancer surgery

Aim: This study aimed to investigate the relationship between preoperative central sensitization (CS) severity and sleep quality with acute postoperative pain levels in female patients undergoing breast cancer surgery. Material and Method: In this prospective observational study, 41 female patients who underwent breast cancer surgery were included. Preoperative CS severity was assessed using the Central Sensitization Inventory (CSI), and sleep quality was evaluated with the Pittsburgh Sleep Quality Index (PSQI). Patients with CSI ≥ 40 were classified as the high CS severity group, and those with PSQI ≥ 5 as the poor sleep quality group. All patients received a standardized multimodal analgesia protocol. Postoperative pain severity was measured using the Numeric Rating Scale (NRS) at 30 minutes, 2, 6, 12, and 24 hours. Additionally, Ramsay Sedation Scale (RSS), Verbal Descriptive Scale (VDS), and Nursing Delirium Screening Scale (NuDESC) were used to evaluate sedation, nausea-vomiting, and delirium, respectively. Results: Among the patients, 61.0% had poor sleep quality and 36.6% had high CS severity. Postoperative NRS scores at rest and with movement were significantly higher in patients with poor sleep quality. Similarly, patients with high CS severity had elevated pain scores at specific time points. A significant positive correlation was found between PSQI and CSI scores (r = 0.663; p < 0.001). Conclusion: Preoperative evaluation using CSI and PSQI may help predict acute postoperative pain risk. Early identification of high-risk patients may guide the development of individualized analgesic strategies.