Are there reliable predictors of postoperative pain?

Ö ÖZ ZE ET T A Am ma aç ç: : Bu ça lış may la has ta nın pre o pe ra tif ba sınç ağ rı eşi ği, ank si ye te ve kor ti zol dü zey le ri ve de mog ra fik ve ri leri ile pos to pe ra tif ağ rı dü ze yi ve anal je zik ih ti ya cı ara sın da ki iliş ki yi de ğer lendir me yi amaç la dık. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Etik ku rul ona yı ve has ta la rın ya zı lı iz ni alın dık tan son ra la pa ros ko pik ko le sis tek to mi uy gu la na cak ASA I-II 40 has ta ça lış ma ya alın dı. Pre o pe ra tif du rum luluk kay gı öl çe ği uy gu lan dı. Ba sınç ağ rı eşi ği her iki el 3 ve 4. par mak pul pa la rın dan al go met re ile öl çül dü. Ope ras yon ön ce si ve son ra sı kor ti zol dü ze yi için kan alın dı. Tra ma dol 50 mg ve ril dik ten son ra has ta kon trol lü anal je zi (HKA) ağ rı pom pa sı 10 mg bo lus, 10 dk ki lit sü re si ayar la na rak ta kıl -dı. Has ta la rın "10., 20., 30." da ki ka lar da ve "2., 4., 6., 12., 24." sa at ler de vi sü el ana log ska la (VAS) sko ru, bo lus doz sa yı sı, bu to na bas ma sa yı sı ve ve ri len anal je zik mik tar la rı kay de dil di. Has ta la rın cin si yet, yaş, beden kitle indeksi, eği tim dü ze yi, anes te zi de ne yi mi, du rum lu luk kay gı pu an la rı, kor ti zol ve ba sınç ağ rı eşi ği dü zey le ri ile pos to pe ra tif VAS, bo lus doz, bu to na bas ma ve ve ri len analje zik mik tar la rı kar şı laş tı rıl dı. B Bu ul l g gu u l la ar r: : Ba sınç ağ rı eşi ği ka dın lar da er kek le re gö re da ha dü şük tü (p= 0.021). Eği tim se vi ye si art tık ça ba sınç ağ rı eşi ği dü ze yin de düş me göz len di (p= 0.016). Er ken posto pe ra tif dö nem de bu to na bas ma sa yı sı en di şe li grup ta an lam lı ola rak yük sek ti. Ba sınç ağ rı eşi ği yük sek olan lar da en di şe dü ze yi da ha az dı (p= 0.03). S So o n nu uç ç: : Pos to pe ra tif ağ rı ve ge re ke bi le cek analje zik mik ta rı has ta la rın fi zik sel ve psi ko lo jik du rum la rı ile bir lik te pre o pe ra tif ola rak plan lan ma lı -dır.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Ağ rı eşi ği; ağ rı, pos to pe ra tif; ank si ye te A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: : In this study, we ai med to eva lu a te the re la ti ons hip bet we en pre o pe ra ti ve pa in pres su re thres hold (PPT), an xi ety, cor ti so l le vels and de mog rap hic da ta of the pa ti ents and level of pos to pe ra ti ve pa in and anal ge sic ne ed. M Ma a t te e r ri i a al l a an nd d M Me et t h ho od ds s: : Fo urty ASA I-II pa ti ents who wo uld un der go la pa ras co pic cho lecy stec tomy we re en rol led in the study af ter et hi cal com met tee ap pro val and writ ten in for med con sents were obtained. Pre o pe ra ti ve con di ti o nal an xi ety sca le was app li ed. PPT was me a su red from 3. and 4. di gi tal pulps of both hands using an al go me ter. Blood was drawn be fo re and af ter sur gery for cor ti so l me a su re ments. Pos to pe ra ti vely 50 mg tra madol was gi ven, pa ti ent con trol led anal ge si a (PCA) pa in pump was in ser ted by ad jus ting 10 mg bo lu...

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“…[25][26][27] Baş ka bir ça lış ma da ise tam tersi ne ka dın la rın da ha az ağ rı duy du ğu be lir til miş -tir. 28 Lynch ve ark.…”

Section: Tar Tiş Maunclassified

Can Postoperative Pain and Analgesic Need be Predicted in Preoperative Period?

Kirdemi̇r¹,

Özorak²

2011

Turkiye Klinikleri J Med Sci

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“…26 In order to improve postsurgical pain management, previous studies have identified several potential predictors of postoperative pain and several preoperative and psychological factors. 12,22,32,41 Among several factors known to affect postsurgical pain, chronic self-reported sleep disturbances before surgery constituted the strongest determinant of pain at rest postoperatively in some surgical patients. 32 Additionally, surgical patients, particularly hospitalized in the Intensive Care Unit (ICU), frequently reported short-term postoperative sleep disturbances/deprivation.…”

Section: Introductionmentioning

confidence: 99%

“…12,22,32,41 Among several factors known to affect postsurgical pain, chronic self-reported sleep disturbances before surgery constituted the strongest determinant of pain at rest postoperatively in some surgical patients. 32 Additionally, surgical patients, particularly hospitalized in the Intensive Care Unit (ICU), frequently reported short-term postoperative sleep disturbances/deprivation. 19,39 These sleep disturbances may result from surgical stress, a disruptive environment (such as noise, lighting, and patient care activities), medical illness itself, and medical treatments (such as respiratory care, drug therapies, and mechanical ventilation).…”

Section: Introductionmentioning

confidence: 99%

Short-Term Sleep Disturbance–Induced Stress Does not Affect Basal Pain Perception, but Does Delay Postsurgical Pain Recovery

Wang

Cao

Wang

et al. 2015

The Journal of Pain

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Chronic sleep disturbance-induced stress is known to increase basal pain sensitivity. However, most surgical patients frequently report short-term sleep disturbance/deprivation during pre- and post-operation periods and have normal pain perception pre-surgery. Whether this short-term sleep disturbance affects postsurgical pain is elusive. We here reported that pre- or post-exposure to rapid eye movement sleep disturbance (REMSD) 6 h daily for 3 consecutive days did not alter basal responses to mechanical, heat, and cold stimuli, but did delay recovery in incision-induced reductions in paw withdrawal threshold to mechanical stimulation and paw withdrawal latencies to heat and cold stimuli on the ipsilateral side of male or female rats. This short-term REMSD led to stress evidenced by an increase in swim immobility time, a decrease in sucrose consumption, and an elevation in the level of corticosterone in serum. Blocking this stress via intrathecal RU38486 or bilateral adrenalectomy abolished REMSD-caused delay in recovery of incision-induced reductions in behavioral responses to mechanical, heat, and cold stimuli. Moreover, this short-term REMSD produced significant reductions in the levels of mu opioid receptor and kappa opioid receptor, but not Kv1.2, in the ipsilateral L4/5 spinal cord and dorsal root ganglia on day 9 post-incision (but not post-sham surgery).

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“…1 postoperative pain has been found to prolong immobilization, postoperative ileus, sleep disorders, and fatigue, all of which may delay hospital discharge, 2 and is a frequent cause of patient dissatisfaction. 3 Effective postoperative analgesia allowing early mobilization is therefore recognized as a prerequisite for Enhanced Recovery After Surgery programs. 4,5 Thoracic epidural analgesia (EA) has been shown to improve postoperative analgesia after open intra-abdominal surgery than parenteral opioids.…”

mentioning

confidence: 99%

Epidural versus Continuous Preperitoneal Analgesia during Fast-track Open Colorectal Surgery

Jouve

Bazin²,

Petit

et al. 2013

Anesthesiology

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Background: Effective postoperative analgesia is essential for early rehabilitation after surgery. Continuous wound infiltration (CWI) of local anesthetics has been proposed as an alternative to epidural analgesia (EA) during colorectal surgery. This prospective, double-blind trial compared CWI and EA in patients undergoing elective open colorectal surgery. Methods: Fifty consecutive patients were randomized to receive EA or CWI for 48 h. In both groups, patients were managed according to Enhanced Recovery After Surgery recommendations. The primary outcome was the dynamic pain score measured during mobilization 24 h after surgery (H24) using a 100-mm verbal numerical scale. Secondary outcomes were time to functional recovery, analgesic technique-related side effects, and length of hospital stay. Results: Median postoperative dynamic pain score was lower in the EA than in the CWI group (10 [interquartile range: 1.6-20] vs. 37 [interquartile range: 30-49], P < 0.001) and remained lower until hospital discharge. The median times to return of gut function and tolerance of a normal, complete diet were shorter in the EA than in the CWI group (P < 0.01 each). Sleep quality was also better in the EA group, but there was no difference in urinary retention rate (P = 0.57). The median length of stay was lower in the EA than in the CWI group (4 [interquartile range: 3.4-5.3] days vs. 5.5 [interquartile range: 4.5-7] days; P = 0.006). Conclusion:Within an Enhanced Recovery After Surgery program, EA provided quicker functional recovery than CWI and reduced length of hospital stay after open colorectal surgery.

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Are there reliable predictors of postoperative pain?

Cited by 58 publications

References 24 publications

Can Postoperative Pain and Analgesic Need be Predicted in Preoperative Period?

Can Postoperative Pain and Analgesic Need be Predicted in Preoperative Period?

Short-Term Sleep Disturbance–Induced Stress Does not Affect Basal Pain Perception, but Does Delay Postsurgical Pain Recovery

Epidural versus Continuous Preperitoneal Analgesia during Fast-track Open Colorectal Surgery

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