Acute Pain, Chronic Post Operative Pain, Opioid Use
Conditions
Keywords
regional anesthesia, peripheral nerve blocks, psychosocial phenotype, pain catastrophizing
Brief summary
The goal of this observational study is to learn about how regional anesthesia (numbing medication) affects pain in patients with different psychosocial phenotypes such as different levels of concern about pain, sleep issues, and anxiety, who are having surgery. The main questions are: 1. Do psychosocial factors such as concerns about pain, sleep, anxiety affect the effectiveness of regional anesthesia? 2. Do psychosocial factors and regional anesthesia affect the amount of opioids used after surgery? 3. Do psychosocial factors and regional anesthesia affect development of chronic postsurgical pain?
Detailed description
A patient's psychological profile importantly modulates pain severity, and the overall experience and impact of pain. For instance, catastrophic thinking about pain, including magnification, rumination, and helplessness, is associated with both greater pain severity and impact. Over the years, regional anesthesia has become an integral part of multimodal pain management for many surgeries. Regional anesthesia (epidural and peripheral nerve blocks) to be associated with superior pain control, reduced time to return of bowel function, shorter intraoperative times, fewer side effects and complications, earlier ambulation and functional exercise capacity post-discharge, lower in-hospital mortality, reduced length-of-stay, improved patient satisfaction, and fewer readmissions. The investigators aim to use of validated psychosocial surveys and semi-structured interviews to understand the phenotype of patients who will benefit the most from regional anesthesia. The investigators also aim to understand how different patient phenotypes and regional anesthesia affect perioperative opioid consumption, and development of chronic postsurgical pain.
Interventions
PROCEDUREregional anesthesia
Patients who underwent surgery and received an epidural or peripheral nerve block
PROCEDUREno regional anesthesia
Patients who underwent surgery and did not received an epidural or peripheral nerve block
OTHERacute pain consultation
Patients who underwent surgery and had a perioperative (preop, intraop, or postop) acute pain consultation
OTHERno acute pain consultation
Patients who underwent surgery and did not have a perioperative (preop, intraop, or postop) acute pain consultation
Sponsors
Brigham and Women's Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 * English speaking * Surgical or procedural patient who will be admitted postoperatively * Willingness to answer psychosocial survey and/or audio recorded semi-structured interview
Exclusion criteria
-Cognitive dysfunction that precludes communication
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maximum pain score over the first 24 hours after surgery | 0-24 hours | Maximum pain score (numerical pain rating score 0-10) over the first 24 hours after surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Worst pain score over the first 24 hours after surgery | 0-24 hours | Worst pain score (numerical pain rating score 0-10) over the first 24 hours after surgery |
| Average pain score over the first 24 hours after surgery | 0-24 hours | Average pain score (numerical pain rating score 0-10) over the first 24 hours after surgery |
| Least pain score over the first 24 hours after surgery | 0-24 hours | Least pain score (0-10) over the first 24 hours after surgery |
| Daily pain scores | 0-7days | Comparison of pain scores (numerical pain rating score 0-10) over the first 7 days after surgery |
| Postoperative opioid consumption | 0-7 days | Comparison of amount of opioids used after surgery (morphine milliequivalents) |
Countries
United States
Contacts
CONTACTYun-Yun K Chen, MD
PRINCIPAL_INVESTIGATORRobert Edwards, PhD
Brigham and Women's Hospital
Outcome results
None listed