Comparative analysis of visual analog scales for assessing acute pain in women after radical mastectomy

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BACKGROUND: Effective quantitative assessment of acute pain as an urgent problem in clinical medicine. One of the solutions to this problem is a color discrete scale (CDS).

AIM: To determine the efficacy of the clinical usage of color discrete scale compared with linear visual analog scale to assess acute pain in women after radical mastectomy.

MATERIALS AND METHODS: This study includes a prospective, observational, and non-randomized clinical trial. A total of 110 females who underwent radical mastectomy (RM) were interviewed. We used a 100-point linear visual analog scale (lVAS) and CDS with monotonic (mCDS) and random (rCDS) color arrangement. Pain was assessed 2, 6, 12, 24, 48, and 72 h after surgery.

RESULTS: Pain scores obtained 2 h after RM were 6 (0; 30), 12 (0; 24), 8 (0; 20) points according to IVAS, mCDS, and rCDS, respectively (p >0.05). Furthermore, the pain scores were gradually reduced on all three scales and had no statistically significant difference (p >0.05). In women who underwent paravertebral blockade (PVB), pain scores were significantly less at 2, 6, 12, and 48 h after surgery (p <0.05). Spearman’s correlation coefficient for lVAS and mCDS is 0.90, 0.86 for lVAS and rCDS, and 0.90 for mCDS and rCDS (all p <0.05).

CONCLUSIONS: The CDS is an alternative, independent, and sufficient tool for quantifying pain. A strong correlation was found between the pain assessments according to CDS and lVAS. PVB significantly improves the quality of pain relief after RM.

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About the authors

Valery V. Yaskevich

Healthcare Institution “Bobruisk Interdistrict Oncologic Dispensary”

Author for correspondence.
ORCID iD: 0000-0001-7428-7823


Belarus, Bobruisk

Alexey V. Marochkov

Healthcare Institution “Mogilev Regional Clinical Hospital”

ORCID iD: 0000-0001-5092-8315

MD, PhD, DSc, Professor

Belarus, Mogilev


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Supplementary files

Supplementary Files
1. Fig. 1. Linear visual analog scale (lVAS)

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2. Fig. 2. Color discrete scale (CDS). 2a – with a monotone sequence of colors (mCDS); 2b – with a random arrangement of colors (rCDS)

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3. Fig. 3. Assessment of the pain syndrome according to lVASH, mCDS and rCDS, (Me (Q1;Q3), max, min)

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