General Anesthesia, Chronic Pain, Postoperative, Acute Pain, Postoperative, Surgery, Anesthesia, Chronic Pain, Analgesic Drugs, Epidural Analgesia, Nephrectomy
Conditions
Keywords
chronic pain, nephrectomy, surgery, pain risk factors, acute pain, postoperative pain
Brief summary
Chronic postoperative pain (CPP) is typically defined as pain persisting for 3 months or more after surgery\[1\]. CPP is a common and increasingly prevalent morbidity, leading to long-term psychological issues, reduced quality of life, and impaired functionality\[2\]. To reduce the incidence of CPP, high-risk patients are identified, and various surgical techniques, pharmacological agents, and regional anesthesia techniques are employed\[3\]. The primary aim of our study is to scale chronic pain at 1 hour, 3 months, and 1 year post-nephrectomy using the Numeric Rating Scale (NRS), ranging from 0 to 10. The secondary aim is to evaluate the effects of factors influencing chronic postoperative pain on the NRS scores.
Detailed description
Patients gender, age, height(m), weight(kg), body mass index(kg/m2), diagnosis, smoking and alcohol history, comorbidities, surgical technique and duration, complications, lymph node dissection, thrombectomy, adrenalectomy, amount of bleeding(cc), need for blood transfusion, need for intensive care, analgesia technique used, amount of opioids and non-opioid analgesics used perioperatively, amount of vasopressors used, heart rate(bpm) and mean arterial pressure(mmHg) at induction, post-intubation, post-extubation, and 1 hour postoperatively, presence of postoperative pain, chronic analgesic use history(more than 3 uses per week), presence of fibromyalgia, frequent urinary tract infections, diagnosed with central sensitization disorders, bruxism, depression-panic attacks, allergic asthma, irritable bowel syndrome, and migraines will be recorded. The effects of these factors on NRS scores at 1 hour, 3 months, and 1 year postoperatively will be examined.
Interventions
DIAGNOSTIC_TESTNumeric Rating Scale
The patients are asked to rate their pain according to the Numeric Rating Scale (0=no pain; 10=worse possible pain).
Sponsors
Istanbul University - Cerrahpasa
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
-Patients aged 18-90 years, * ASA I-IV, * undergoing elective nephrectomy under general anesthesia will be included in the study.
Exclusion criteria
* Patients who cannot be reached by phone and hose who die within the 1-year postoperative period will be excluded from the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| NRS 1 hour | 1 hour after the end of the surgery | The patients are asked to rate their pain according to the Numeric Rating Scale (0=no pain; 10=worse possible pain). Patients with NRS equal or higher than 4 are defined as painfull; and, patients with NRS lower than 4 are defined as pain-free |
| NRS 3 months | 3 months after the surgery | The patients are asked to rate their pain according to the Numeric Rating Scale (0=no pain; 10=worse possible pain). Patients with NRS equal or higher than 4 are defined as painfull; and, patients with NRS lower than 4 are defined as pain-free |
| NRS 1 year | 1 year after the surgery | The patients are asked to rate their pain according to the Numeric Rating Scale (0=no pain; 10=worse possible pain). Patients with NRS equal or higher than 4 are defined as painfull; and, patients with NRS lower than 4 are defined as pain-free |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| age | At the time of preoperative assesment | Age of the patiens as years |
| height | At the time of preoperative assesment | Height of the patiens as meter |
| BMI | At the time of preoperative assesment | body mass index of the patiens as kg/m2 |
| smoking | At the time of preoperative assesment | Data of the patient if they are smoking or not |
| Amount of opioid and non-opioid analgesics used perioperatively | At the time of perioperative assesment | Amount of opioid and non-opioid analgesics used perioperatively |
| Gender | At the time of preoperative assesment | Woman or man |
| Comorbidities | At the time of preoperative assesment | hipertension, diabetus mellitus, asthma or cardiac disease etc. |
| surgical technique | At the time of perioperative assesment | radical or partial nephrectomy and open or laparoscopic nephrectomy |
| surgical duration | The time recorded at the end of the surgery will be reported | How long does the surgery take in minutes? |
| additional procedures next to the nephrectomy | At the time of perioperative assesment | lymph node dissection, thrombectomy, adrenalectomy procedures used |
| need for blood transfusion | At the time of perioperative assesment | How many blood product tranfusions were required? |
| need for intensive care units | At the time of postoperative assesment, the data evaluated at the end of the surgery will be reported | Whether there is a need for intensive care after surgery |
| Analgesia technique | At the time of perioperative assesment | Epidural analgesia or intravenous analgesia was used as analgesic technique |
| Amount of vasopressors used | At the time of perioperative assesment | Amount of vasopressors used at the perioperative period |
| Value of postoperative acute pain score on NRS score | 1 hour postoperative period | Value of postoperative acute pain score on NRS score(0:no pain, 10:the worst pain imaginable) |
| Chronic analgesic use history | 1 year before the operation | More than 3 uses per a week |
| Clinical conditions that will be reported under the title of central sensitization disorder | At the time of preoperative assesment | Presence of fibromyalgia, frequent urinary tract infection, bruxism, diagnosed with depression-panic attack, allergic asthma, irritable bowel syndrome and migraines will be recorded. |
Countries
Turkey (Türkiye)
Contacts
STUDY_DIRECTORAylin Nizamoglu, Doctor
Istanbul Univerisity-Cerrahpasa Cerrahpasa Faculty of Medicine
STUDY_CHAIRSafak E Erbabacan, associate professor
Istanbul Univerisity-Cerrahpasa Cerrahpasa Faculty of Medicine
STUDY_CHAIRFatis Altindas, Professor
Istanbul Univerisity-Cerrahpasa Cerrahpasa Faculty of Medicine
PRINCIPAL_INVESTIGATORIlayda Bilgili Altuntas, Physician
Istanbul Univerisity-Cerrahpasa Cerrahpasa Faculty of Medicine
Outcome results
None listed