Predictors of Postoperative Pain and Analgesic Consumption

Abstract

Pain is a subjective and multidimensional experience that is often inadequately managed in clinical practice. Effective control of postoperative pain is important after anesthesia and surgery. A systematic review was conducted to identify the independent predictive factors for postoperative pain and analgesic consumption. The authors identified 48 eligible studies with 23,037 patients included in the final analysis. Preoperative pain, anxiety, age, and type of surgery were four significant predictors for postoperative pain. Type of surgery, age, and psychological distress were the significant predictors for analgesic consumption. Gender was not found to be a consistent predictor as traditionally believed. Early identification of the predictors in patients at risk of postoperative pain will allow more effective intervention and better management. The coefficient of determination of the predictive models was less than 54%. More vigorous studies with robust statistics and validated designs are needed to investigate this field of interest.

Efficacy of pregabalin in relieving acute postoperative pain- systemic Review & meta-analysis

“…This is in accordance with few earlier studies. 12 The type of anaesthesia also predicted 2 hour pain scores on movement and 24 hour opioid consumption, likely due to the analgesic effect of regional anaesthesia in the early postoperative period. [13][14][15][16] …”

Baseline Morphine Consumption May Explain Between-Study Heterogeneity in Meta-analyses of Adjuvant Analgesics and Improve Precision and Accuracy of Effect Estimates

“…Importantly, baseline risk encompasses many different participant and trial characteristics such as age, sex, concurrent analgesic protocols and other factors shown to influence postoperative morphine consumption. 137 In our previous meta-analysis with gabapentin, morphine consumption varied even within procedure-specific subgroups and type of surgery was a small determinant of heterogeneity between studies in relation to morphine consumption and pain scores. 10 Our results suggest that expected postoperative morphine consumption (as a surrogate for pain, participant characteristics and concurrent analgesia) is a large determinant of heterogeneity between studies.…”

“…Finally, we included trials from a variety of patient populations with differing clinical characteristics (co-morbidity for example), differing analgesic protocols and healthcare systems, which may all influence morphine consumption. 137 However, the use of a fixed consumption of morphine should have controlled for these differences when analyzing baseline risk.…”

Why anesthesiologists need to care about the way chronic pain is managed

“…9 A recent review clearly indicates that preoperative pain, anxiety, age, and type of surgery are four significant predictors of postoperative pain. 10 By being aware of these factors and taking them into account, the anesthesiologist may have an impact not only on pain in the immediate postoperative period but also on the longer term recovery.…”

“…9 Un compte-rendu récent indique clairement que la douleur préopératoire, l'anxiété, l'âge et le type de chirurgie sont quatre prédicteurs significatifs de douleur postopératoire. 10 En étant conscient de ces facteurs et en en tenant compte, l'anesthésiologiste peut avoir un impact non seulement sur la douleur en période postopératoire immédiate, mais également sur le rétablissement à long terme de son patient.…”