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Fig 1.

Schematic illustration of the study protocol.

The day before scheduled surgery patients completed the Demographic, B-MEPS tool, and Central Sensitization Inventory (CSI). Then, patients underwent a series of experimental pain tests: Pressure pain threshold (PPT), pressure pain tolerance (PPTol) and conditioned pain modulation test (CPM) and blood sample analysis. During postoperative days 1–3 pain-related outcomes were assessed, including postoperative rest pain and movement-evoked pain intensity, and morphine Rehabilitation Questionnaire (QoR-15) was applied on the 3rd day.

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Table 1.

The refined version of B-MEPS tool.

Instruction to patients: “These questions aim to assess your feelings of stress related to the perioperative period”.

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Fig 2.

Flow chart of the study.

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Table 2.

Demographic and clinical characteristics, preoperative predictors and postoperative outcomes (n = 150).

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Table 3.

Spearman’s rank correlation matrix for preoperative, transoperative, and postoperative variables.

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Table 4.

Coefficients from generalized linear model of preoperative emotional stress (B-MEPS) and preoperative predictors.

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Table 5.

MANCOVA model for pre- and postoperative pain variables comparing low or high psychological stress according to B-MEPS tool*.

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Table 6.

Parameter estimates from repeated measures of Visual analogue scale for movement-evoked pain intensity using mixed model analysis.

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Table 7.

Generalized linear model with dependent variable morphine consumption in 48 hours.

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Table 8.

Result for univariate analysis of variance for QoR-15 rehabilitation.

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Fig 3.

Infographic of preoperative emotional stress and postoperative pain.

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Fig 4.

Acute movement-evoked postoperative pain at 12, 24 and 48 hours.

NPS 0–3: low pain, NPS 4–6: moderate pain, NPS 7–10: severe pain. NPS, Numeric Pain Scale.

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