Screen Addiction and Postoperative Pain

Problematic smartphone use-often referred to as smartphone addiction-has emerged as a significant behavioral concern worldwide. Prior research has demonstrated associations between excessive smartphone use and anxiety, depression, sleep disturbances, impaired attention, and increased musculoskeletal discomfort. Moreover, psychological factors such as stress, anxiety, and cognitive attention patterns are known to modulate postoperative pain perception.

Individuals with higher levels of smartphone addiction commonly exhibit elevated anxiety, restlessness, and depressive symptoms, which may heighten pain sensitivity and interfere with postoperative pain coping mechanisms. However, current literature includes limited evidence directly examining the relationship between smartphone addiction and postoperative pain outcomes.

This single-center prospective observational study will include adult patients aged 18-45 years undergoing elective rhinoplasty surgery under general anesthesia. Eligible participants will be ASA physical status I-II and without psychiatric disorders, chronic analgesic or psychotropic medication use, communication difficulties, prior rhinoplasty surgery, or additional concurrent surgical procedures.

Preoperative data collection will include demographic variables (age, sex, education level, duration of daily smartphone use). Participants will complete two validated instruments in Turkish: The Smartphone Application-Based Addiction Scale - Turkish Version, The Nomophobia Questionnaire (NMP-Q) - Turkish Version.

Surgical and anesthesia management will follow standardized institutional protocols. Postoperative pain will be assessed using the Visual Analog Scale (VAS) at 1, 6, 12, and 24 hours following surgery. Total analgesic consumption within the first 24 hours will also be recorded.

Participants will be categorized based on their smartphone addiction scores, and postoperative pain outcomes and analgesic consumption will be compared between groups. Additionally, correlation analyses will be performed to explore the association between smartphone addiction levels and perceived postoperative pain.

Sample size was calculated using an effect size derived from a previous study reporting a correlation coefficient of rho = 0.292 between problematic phone use and perceived pain. With a significance level of 0.05 and a statistical power of 80%, a minimum of 91 participants were required. To compensate for an anticipated dropout rate of approximately 10%, the final planned sample size is 100 participants.

Inclusion criteria

• Adults aged 18-45 years
• Scheduled for elective primary rhinoplasty under general anesthesia
• ASA physical status I-II
• Ability to provide informed consent

Exclusion criteria

• History of psychiatric disorders (diagnosed anxiety, depression, bipolar disorder, psychosis)
• Use of chronic analgesic, opioid, sedative, or psychotropic medication
• Previous rhinoplasty or combined surgeries
• Neurological disorders affecting pain perception
• Communication difficulties or inability to complete questionnaires
• Chronic pain syndromes (e.g., fibromyalgia, chronic back pain)
• Intraoperative complications requiring deviation from standard anesthesia