Postoperative Pain Trajectories in Cardiac Surgery Patients

Overview

Journal Pain Res Treat

Date 2012 Mar 27

PMID 22448322

Citations 15

Authors

C Richard Chapman

Ruth Zaslansky

Gary W Donaldson

Amihay Shinfeld

Affiliations

Soon will be listed here.

Abstract

Poorly controlled postoperative pain is a longstanding and costly problem in medicine. The purposes of this study were to characterize the acute pain trajectories over the first four postoperative days in 83 cardiac surgery patients with a mixed effects model of linear growth to determine whether statistically significant individual differences exist in these pain trajectories, and to compare the quality of measurement by trajectory with conventional pain measurement practices. The data conformed to a linear model that provided slope (rate of change) as a basis for comparing patients. Slopes varied significantly across patients, indicating that the direction and rate of change in pain during the first four days of recovery from surgery differed systematically across individuals. Of the 83 patients, 24 had decreasing pain after surgery, 24 had increasing pain, and the remaining 35 had approximately constant levels of pain over the four postoperative days.

Citing Articles

Effect of acute postsurgical pain trajectories on 30-day and 1-year pain.

Awadalla S, Winslow V, Avidan M, Haroutounian S, Kannampallil T PLoS One. 2022; 17(6):e0269455.

PMID: 35687544 PMC: 9187125. DOI: 10.1371/journal.pone.0269455.

The Efficacy of Ropivacaine 0.5% in Transversus Abdominis Plane Block to Relieve the Postoperative Pain of Female Laparoscopic Surgery Grade II.

Rouholamin S, Ghahiri A, Dehghan Khalili B Adv Biomed Res. 2022; 11:12.

PMID: 35386544 PMC: 8977607. DOI: 10.4103/abr.abr_46_20.

Trajectories of Pain After Cardiac Surgery: Implications for Measurement, Reporting, and Individualized Treatment.

Mori M, Brooks 2nd C, Dhruva S, Lu Y, Spatz E, Dey P Circ Cardiovasc Qual Outcomes. 2021; 14(8):e007781.

PMID: 34304586 PMC: 8366534. DOI: 10.1161/CIRCOUTCOMES.120.007781.

AAAPT: Assessment of the Acute Pain Trajectory.

Bayman E, Oleson J, Rabbitts J Pain Med. 2021; 22(3):533-547.

PMID: 33735384 PMC: 7971475. DOI: 10.1093/pm/pnaa440.

Patient and Procedural Determinants of Postoperative Pain Trajectories.

Vasilopoulos T, Wardhan R, Rashidi P, Fillingim R, Wallace M, Crispen P Anesthesiology. 2021; 134(3):421-434.

PMID: 33449996 PMC: 8726009. DOI: 10.1097/ALN.0000000000003681.

References

BALLANTYNE J, Carr D, deFerranti S, Suarez T, Lau J, CHALMERS T . The comparative effects of postoperative analgesic therapies on pulmonary outcome: cumulative meta-analyses of randomized, controlled trials. Anesth Analg. 1998; 86(3):598-612. DOI: 10.1097/00000539-199803000-00032. View

Donaldson G, Moinpour C . Individual differences in quality-of-life treatment response. Med Care. 2002; 40(6 Suppl):III39-53. DOI: 10.1097/00005650-200206001-00007. View

Goebel S, Baumann B, Steinert A, Reppenhagen S, Faller H . [Elevated postoperative pain levels following orthopedic surgery. Depression as a strong predictor]. Schmerz. 2010; 24(1):54-61. DOI: 10.1007/s00482-009-0883-5. View

Wu C, Raja S . Treatment of acute postoperative pain. Lancet. 2011; 377(9784):2215-25. DOI: 10.1016/S0140-6736(11)60245-6. View

Mehta P, West S . Putting the individual back into individual growth curves. Psychol Methods. 2000; 5(1):23-43. DOI: 10.1037/1082-989x.5.1.23. View

de Williams A, Davies H, Chadury Y . Simple pain rating scales hide complex idiosyncratic meanings. Pain. 2000; 85(3):457-463. DOI: 10.1016/S0304-3959(99)00299-7. View

Wheeler M, Oderda G, Ashburn M, Lipman A . Adverse events associated with postoperative opioid analgesia: a systematic review. J Pain. 2003; 3(3):159-80. DOI: 10.1054/jpai.2002.123652. View

Werner M, Soholm L, Rotboll-Nielsen P, Kehlet H . Does an acute pain service improve postoperative outcome?. Anesth Analg. 2002; 95(5):1361-72, table of contents. DOI: 10.1097/00000539-200211000-00049. View

Perkins F, Kehlet H . Chronic pain as an outcome of surgery. A review of predictive factors. Anesthesiology. 2000; 93(4):1123-33. DOI: 10.1097/00000542-200010000-00038. View

10.

Marks R, SACHAR E . Undertreatment of medical inpatients with narcotic analgesics. Ann Intern Med. 1973; 78(2):173-81. DOI: 10.7326/0003-4819-78-2-173. View

11.

Strulov L, Zimmer E, Granot M, Tamir A, Jakobi P, Lowenstein L . Pain catastrophizing, response to experimental heat stimuli, and post-cesarean section pain. J Pain. 2006; 8(3):273-9. DOI: 10.1016/j.jpain.2006.09.004. View

12.

Werner M, Mjobo H, Nielsen P, Rudin A . Prediction of postoperative pain: a systematic review of predictive experimental pain studies. Anesthesiology. 2010; 112(6):1494-502. DOI: 10.1097/ALN.0b013e3181dcd5a0. View

13.

Holte K, Kehlet H . Effect of postoperative epidural analgesia on surgical outcome. Minerva Anestesiol. 2002; 68(4):157-61. View

14.

Gerbershagen H, Dagtekin O, Gaertner J, Petzke F, Heidenreich A, Sabatowski R . Preoperative chronic pain in radical prostatectomy patients: preliminary evidence for enhanced susceptibility to surgically induced pain. Eur J Anaesthesiol. 2010; 27(5):448-54. DOI: 10.1097/EJA.0b013e3283349d9a. View

15.

Eisenberg E, Pultorak Y, Pud D, Bar-El Y . Prevalence and characteristics of post coronary artery bypass graft surgery pain (PCP). Pain. 2001; 92(1-2):11-7. DOI: 10.1016/s0304-3959(00)00466-8. View

16.

DeLoach L, Higgins M, Caplan A, Stiff J . The visual analog scale in the immediate postoperative period: intrasubject variability and correlation with a numeric scale. Anesth Analg. 1998; 86(1):102-6. DOI: 10.1097/00000539-199801000-00020. View

17.

Wildgaard K, Ravn J, Kehlet H . Chronic post-thoracotomy pain: a critical review of pathogenic mechanisms and strategies for prevention. Eur J Cardiothorac Surg. 2009; 36(1):170-80. DOI: 10.1016/j.ejcts.2009.02.005. View

18.

Richard Chapman C, Davis J, Donaldson G, Naylor J, Winchester D . Postoperative pain trajectories in chronic pain patients undergoing surgery: the effects of chronic opioid pharmacotherapy on acute pain. J Pain. 2011; 12(12):1240-6. DOI: 10.1016/j.jpain.2011.07.005. View

19.

Kalkman J, Visser K, Moen J, Bonsel J, Grobbee E, Moons M . Preoperative prediction of severe postoperative pain. Pain. 2003; 105(3):415-423. DOI: 10.1016/S0304-3959(03)00252-5. View

20.

Gotoda Y, Kambara N, Sakai T, Kishi Y, Kodama K, Koyama T . The morbidity, time course and predictive factors for persistent post-thoracotomy pain. Eur J Pain. 2001; 5(1):89-96. DOI: 10.1053/eujp.2001.0225. View