• A Ahmed, F Khan, M Ali, F Haqnawaz, A Hussain, and S I Azam.
• Department of Anaesthesia, Aga Khan University, Karachi, Pakistan. aliya.ahmed@aku.edu
• Acta Anaesthesiol Scand. 2012 May 1;56(5):629-35.

BackgroundResearch has shown that menstrual cycle phase may affect pain sensitivity. There is a lack of studies evaluating this effect on post-operative pain and analgesic needs.MethodsIn this prospective cohort study, we determined the effect of menstrual cycle phase on pain perception and analgesic requirements following total abdominal hysterectomy. Sixty women with regular menstrual cycles undergoing elective surgery were recruited and divided into 'follicular' and 'luteal' groups according to their menstrual history. Post-operative pain was managed with intravenous patient-controlled analgesia using tramadol. Intravenous morphine was used for rescue analgesia, and pain was assessed for 24 h.ResultsPain scores in the recovery room and ward six and 24 h post-operatively were similar in the groups at rest and on coughing. Pain scores at rest 12 h post-operatively were significantly higher in the luteal group (P = 0.043), while they were similar on coughing. There was no significant difference in the total tramadol requirement. Number of patients requiring rescue analgesia and the amount of morphine used was also similar.ConclusionThere was no difference in pain scores or analgesic requirements between the two groups except for rest pain at 12 h, which was significantly higher in the luteal group. As pain was assessed at 13 different time points, a significant difference seen only at one point could be due to random chance. We suggest that future research should concentrate on studying this issue in patients of relatively younger age groups with more pronounced hormonal variations during the cycle.© 2012 The Authors. Acta Anaesthesiologica Scandinavica © 2012 The Acta Anaesthesiologica Scandinavica Foundation.

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