Evaluation of a Novel Web-based Application for Monitoring Postoperative Pain in Patients Underwent Total Ankle Replacement

Background:

The management of postoperative pain in patients undergoing total ankle replacement is routinely based on one of the two following drugs: tapentadol and oxycodone/naloxone (Nett, 2010). The drugs are used with similar frequencies. Indeed, previous studies compared the two drugs in terms of efficacy in reducing postoperative pain and frequency of side effects, in the field of orthopaedic and trauma surgery (Haeseler, 2017, Hartrick, 2009). The studies demonstrated that there are no substantial differences.

With regard to pain monitoring, the gold standard is the visual-analogue scale (VAS), which allows the patient to indicate the pain level as a score ranging from 0 to 10 (from minimum to maximum) (Campbell, 1990). Recently, a pain monitoring web-based application has been developed and distributed: 'NavigatePain' (NavigatePain, Aglance Solutions, Denmark). The app can be used in a simple and intuitive manner by PC, smartphone or tablet devices (Boudreau, 2016; Matthews, 2018). Moreover, physicians can easily schedule postoperative self-monitoring sessions for the patients (exploiting automatic notification messages sent by e-mail). The app allows the user to draw the pain areas in the frontal, posterior and lateral body planes, providing an index that quantifies the percentage of pain area with respect to the total body area in the considered plane. VAS score and notes reporting side effects can be reported as well in the app. Compared to VAS score, the pain area index is differentiated in the body planes and can represent a complementary and more specific source of information in monitoring postoperative pain.

Aim of the study:

The study evaluates the NavigatePain app for monitoring the postoperative pain in patients undergoing total ankle replacement, from preoperative condition to 30 days follow-up. The indexes provided by the app in terms of percentages of pain areas are compared to VAS reference score. Moreover, the relation between the percentage of pain area and the presence of side effects of the intervention are compared as well.