Chronic postoperative pain
Conditions
Sponsors
Amsterdam University Medical Center, location Meibergdreef (AMC)
Eligibility
Inclusion criteria
Inclusion criteria: Patients aged 18 years or older 2. Willing and able to provide informed consent 3. Undergoing a surgical procedure with an increased risk of CPSP (amputation, spinal surgery, thoracotomy, breast surgery, herniotomy, hysterectomy and after arthroplasty) (9). Or; Any surgical procedure and one of the following: - Diagnosed chronic pain, defined according to the ICD-11 as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Chronic pain is pain that persists or recurs for longer than 3 months (3)” - Chronic opioid use, defined as > 20 mg daily morphine equivalent (MME) consumption for more than 3 months in the last 3 months - Allergy to opioid agents - Patients with pain device implants, such as intrathecal pain pump, spinal cord stimulation or peripheral nerve stimulator - The usage of pain medication as methadone, buprenorphine, anticonvulsants, antidepressants or medicinal cannabis for chronic pain for more than 3 months in the last three months - Psychosocial comorbidities like anxiety, depression, pain catastrophizing if documented in the electronic medical record
Exclusion criteria
Exclusion criteria: - Patients who undergo emergency surgery are excluded to ensure sufficient time for the informed consent process. - Patients undergoing implementation of pain device implants, such as intrathecal pain pump, spinal cord stimulators or peripheral nerve stimulator. - Patients who undergo surgery that most likely leads to prolonged sedation and for that reason cannot fill in the QoR-15 questionnaire at day three postoperative.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome is the between group difference in Quality of Recovery (QoR)-15 questionnaire score at day three after surgery. | — |
Secondary
| Measure | Time frame |
|---|---|
| - Postsurgical chronic pain (CPSP) at three and six months after surgery, defined according to the IASP (as mentioned in chapter 1), and/or taking pain medication to treat CPSP as described above. - Opioid consumption per day, calculated as morphine equivalent dose (MEDs) at day three after surgery, prescription at discharge, and at three and six months after discharge. - Patient-reported outcome as measured by the WHODAS 2.0 (15), PROMIS-29 (16) and EQ-5D-5L (17) preoperatively and at three and six months after discharge. | — |
Contacts
Public ContactManouk Admiraal
Amsterdam UMC, locatie Meibergdreef
Outcome results
None listed