Moderate to severe preoperative pain (OR= 3.60, 95% CI: 1.13–11.44, P = .03), COMT rs6269 GA genotype (OR = 5.03, 95% CI: 1.49—17.04, P = .009) and psychological distress at postoperative day 14 (OR= 1.08, 95% CI: 1.02—1.16, P = .02) were identified as risk factors. This evidence concerns the gene COMT and Abnormal emotional state.