Coronary Artery Bypass Grafting, Postoperative Pain
Conditions
Keywords
Pain Neuroscience Education, Coronary Artery Bypass Grafting, CABG, Postoperative Pain, Chronic Postoperative Pain, Pain Catastrophizing, Pain Vigilance, Pressure Pain Threshold
Brief summary
This randomized controlled trial evaluated the effects of a single preoperative pain neuroscience education (PNE) session on postoperative pain-related outcomes in patients undergoing elective coronary artery bypass grafting (CABG). Participants were randomly allocated to either a PNE group, which received a structured preoperative PNE session in addition to routine preoperative care, or a control group, which received routine preoperative information and care. Outcomes included pain intensity, pain catastrophizing, pain vigilance and awareness, and pressure pain threshold. Assessments were conducted preoperatively and at 24 hours, 1 month, and 3 months after surgery.
Detailed description
This study was designed as a prospective, two-arm, parallel-group randomized controlled trial involving patients scheduled for elective coronary artery bypass grafting (CABG). The study investigated whether preoperative pain neuroscience education could influence acute and persistent postoperative pain-related outcomes following CABG. Participants were randomly allocated to an intervention group or a control group. Participants in the intervention group received a structured pain neuroscience education session before surgery in addition to routine preoperative care. The educational session addressed the neurophysiology of pain, the role of the nervous system and brain in pain perception, factors that may influence pain experiences, common misconceptions about pain, and strategies for understanding and coping with postoperative pain. Participants in the control group received routine preoperative information and care without structured pain neuroscience education. Assessments were performed at baseline before surgery and at 24 hours, 1 month, and 3 months after surgery. Pain intensity was assessed using a visual analog scale (VAS). Pain-related cognitive and attentional factors were assessed using the Pain Catastrophizing Scale (PCS) and Pain Vigilance and Awareness Questionnaire (PVAQ). Pressure pain threshold (PPT) was assessed using a digital pressure algometer. The study aimed to determine whether a brief preoperative educational intervention targeting pain-related knowledge and beliefs could improve postoperative pain and pain-related outcomes in patients undergoing CABG.
Interventions
BEHAVIORALPain Neuroscience Education
Participants received a structured pain neuroscience education session preoperatively in addition to routine preoperative care. The education addressed the neurophysiology of pain, the role of the nervous system and brain in pain perception, factors influencing the pain experience, common pain-related misconceptions, and strategies for understanding and coping with postoperative pain.
Sponsors
İsmail Palalı
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Intervention model description
Participants undergoing elective CABG were randomly allocated to either a preoperative pain neuroscience education group or a control group receiving routine preoperative care.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adults aged 18 years or older Scheduled for elective coronary artery bypass grafting (CABG) through median sternotomy Able to understand and communicate sufficiently to participate in the education and outcome assessments Provided informed consent to participate in the study
Exclusion criteria
Emergency CABG surgery Concomitant cardiac surgical procedures other than CABG Inability to understand or participate in the pain neuroscience education session Cognitive or communication impairment preventing completion of study assessments Postoperative clinical conditions preventing participation in the planned assessments
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cough-Evoked Surgical-Site Pain Intensity at 3 Months | 3 months after surgery | Cough-evoked pain intensity at the surgical site was assessed using a 0-10 pain rating scale, with higher scores indicating greater pain intensity. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cough-Evoked Surgical-Site Pain Intensity | 24 hours and 1 month after surgery | Cough-evoked pain intensity at the surgical site was assessed using a 0-10 pain rating scale, with higher scores indicating greater pain intensity. |
| Pain Catastrophizing | Baseline, 1 month, and 3 months after surgery | Pain catastrophizing was assessed using the Pain Catastrophizing Scale (PCS). The PCS consists of 13 items scored from 0 to 4, yielding a total score ranging from 0 to 52. Higher scores indicate greater pain catastrophizing. |
| Pain Vigilance and Awareness | Baseline, 1 month, and 3 months after surgery | Pain-related vigilance and attention were assessed using the Pain Vigilance and Awareness Questionnaire (PVAQ). The PVAQ consists of 16 items, with higher total scores indicating greater attention to and vigilance for pain. |
| Local Pressure Pain Threshold | Baseline, 1 month, and 3 months after surgery | Local mechanical pain sensitivity was assessed using pressure pain threshold (PPT) testing with a pressure algometer at a site adjacent to the sternotomy region. The pressure at which the sensation first became painful was recorded, with higher PPT values indicating lower mechanical pain sensitivity. |
| Remote Pressure Pain Threshold | Baseline, 1 month, and 3 months after surgery | Remote mechanical pain sensitivity was assessed using pressure pain threshold (PPT) testing with a pressure algometer at a site remote from the surgical area. The pressure at which the sensation first became painful was recorded, with higher PPT values indicating lower mechanical pain sensitivity |
| Chronic Postsurgical Pain | 3 months after surgery | The presence of chronic postsurgical pain (CPSP) was assessed at 3 months after CABG based on the presence of persistent pain related to the surgical procedure. |
Countries
Turkey (Türkiye)
Outcome results
None listed