Chronic Postoperative Pain
Conditions
Brief summary
Chronic postoperative pain has an overall incidence of approximately 30%, with 5% to 10% of cases classified as severe (numerical rating scale \> 6/10). However, its management remains suboptimal, primarily due to underdiagnosis and delayed referral of patients to specialized chronic pain centers. Improving the screening of patients with chronic postoperative pain is therefore crucial. Our research has shown that early detection of postoperative neuropathic pain is possible using just two text messages (SMS), as early as three months after surgery. Early screening, combined with prompt management, can prevent pain from becoming chronic and mitigate its harmful effects. Study design This study is a cluster crossover randomized trial. All participating centers (n=16) will take part in two sequential study periods: * Control Period: Without early treatment at 3 months During this period, patients with persistent postoperative pain-identified via SMS-will receive treatment at 6 months. This reflects the current standard of care for patients with postoperative pain. * Intervention Period: With early treatment at 3 months During this period, patients with persistent postoperative pain-identified via SMS-will receive early treatment starting at 3 months. Study Population The study will include patients undergoing the following minor surgical procedures: * Inguinal hernia repair * Breast reduction * Mastectomy with lymph node dissection * Knee arthroscopy * Knee ligament reconstruction Study Schedule Recruitment Period: 24 months Patient Follow-up: 6 months Total Estimated Study Duration: 30 months
Interventions
OTHEREarly management of postoperative pain at 3 months detected using sms
During this period, patients with persistent post-operative pain, identified through SMS screening, will receive early treatment starting at 3 months.
Sponsors
Fondation Hôpital Saint-Joseph
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
SCREENING
Masking
NONE
Intervention model description
This study is a cluster crossover randomized trial. All participating centers (n=16) will take part in two sequential study periods: * Control Period: Without early treatment at 3 months During this period, patients with persistent postoperative pain-identified via SMS-will receive treatment at 6 months. This reflects the current standard of care for patients with postoperative pain. * Intervention Period: With early treatment at 3 months During this period, patients with persistent postoperative pain-identified via SMS-will receive early treatment starting at 3 months. Each center will be randomized into one of two sequences: control period followed by intervention period or intervention period followed by control period.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients who have undergone one of the following procedures: * Inguinal hernia repair, regardless of the surgical technique used * Breast reduction * Mastectomy with or without reconstruction but with lymph node dissection * Knee arthroscopy or knee ligamentoplasty * Patients with a smartphone * French-speaking patients * Patients affiliated with a social security * Patients who have given their free and informed verbal consent
Exclusion criteria
* Patients with pain sensitivity defined by the presence of chronic pain, use of level 3 morphine analgesics, use of anxiolytics, gabapentinoids and/or antidepressants * Patients subject to legal protection measures * Patients deprived of their liberty * Pregnant, labouring or breastfeeding patients
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Proportion of patients with chronic post-operative pain at 6 months. | 6 months post-operative |
Secondary
| Measure | Time frame |
|---|---|
| Types of chronic post-operative pain at 3 and 6 months: frequency of neuropathic pain and pain due to excessive nociception | 3 and 6 months post-operative |
| Proportion of patients responding to SMS during the various assessments | 3 and 6 months post-operative |
| Sensitivity and specificity of SMS for diagnosing pain with neuropathic characteristics post-operatively at 3 and 6 months | 3 and 6 month post-operative |
| Proportion of patients with pain at 3 and 6 months according to the type of surgery | 3 and 6 months post-operative |
Countries
France
Contacts
Primary ContactFrédéric ADAM, Doctor of Medicine
Backup ContactCélia MAMMA
Outcome results
None listed