Pain, Postoperative
Conditions
Brief summary
Following surgery, some but not all patients develop persistent (or chronic) postoperative pain CPSP. Several risk factors for this persistent pain have been confirmed in previous studies, but neither surgeons nor anesthesiologists have or take the time to systematically screen patients for this risk. However, hospital information systems often contain the data already, entered during preoperative consultations (e.g. chronic opioid medication) or obtained during the postoperative period (e.g. pain scores). Here the investigators test an automatic detection algorithm which alerts the analgesia team when a patient at risk of CPSP is or has been operated.
Detailed description
The primary aim of the study is to confirm that the sensitivity of the automatic alert is at least 80%, i.e. that 80% of patients with the primary outcome had an automatic alert. The secondary aim of the study is to develop an algorithm (combination of risk factors) with which the specificity of the alert can be improved.
Interventions
DIAGNOSTIC_TESTautomatic risk detection
automatic alert of the risk for CPSP, triggered by one of the following entries in the hospital information system: psychological risk factors (depression, anxiety, PTSD, catastrophizing, high pain anticipation), chronic use of benzodiazepines or opioids, intense postoperative pain or need of large opioid doses in the recovery room
Sponsors
Benno Rehberg-Klug
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 18 years of age * elective surgery * perioperative use of the hospital information system * surgery of the following types: endoprosthesis of the knee or shoulder, amputation other than toe or finger, spinal surgery, cardio-thoracic thoracotomy, laparotomy, inguinal hernia repair, breast surgery
Exclusion criteria
* inability to read and understand the consent form or the questionnaires * emergency surgery * having already participated in the study for another surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| CPSP at 6 months | 6 months | mean pain intensity in the brief pain inventory of at least 3/10 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| CPSP at 12 months | 12 months | mean pain intensity in the brief pain inventory of at least 3/10 |
| neuropathic pain at 6/12 months | 6/12 months | mean pain intensity in the brief pain inventory of at least 3/10 AND a DN4 score of at least 4 |
| clinically significant pain at 6/12 months | 6/12 months | either a pain intensity of \>=3 at rest or \>=5 on movement or use of analgesics |
| pain-related functional deficit at 6/12 months | 6/12 months | pain interference scales of the brief pain inventory, number of days not working |
| persistent opioid use | 6/12 months | patient reported use of tramadol (yes/no) or use of strong opioids (yes/no) |
| acute postoperative pain | 24h postoperative | mean pain score and highest pain score in the first 24h postoperative on a 0-10 verbal numeric rating scale |
Countries
Switzerland
Outcome results
None listed