Prediction of Acute Postoperative Pain and Analgesic Consumption by Preoperative Responses to Experimental Pain in Patients Undergoing Chest Wall Surgery
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 40
- 试验地点
- 1
- 主要终点
- Postoperative pain unpleasantness
研究概览
简要总结
Pain is an expected part of surgical recovery but effective pain management remains challenging. The high variability in postoperative pain experience and analgesic treatment response between patients is part of the challenge. Few studies have yet combined preoperative assessment of responses to experimental pain with measurements of cognitive and emotional processes in the prediction of postoperative pain.
We hypothesize, that preoperative evoked brain potentials (using standard electroencephalographic brain imaging), endogenous pain inhibition capacity (conditioned pain modulation), responses to pressure/thermal pain stimulation, and/or situational pain-related catastrophic thinking are useful clinical predictors of postoperative pain and analgesic consumption.
详细描述
Preselected preoperative predictor variables/individual patient characteristics include the following:
- Evoked brain potentials (using standard electroencephalographic brain imaging)
- Capacity of descending pain inhibition induced by a cold pressor test (2C in 120 sec)
- Pressure pain detection and tolerance thresholds in muscle (m.quadriceps)
- Pressure pain tolerance thresholds in bone (sternum and tibia)
- Heat pain tolerance threshold in skin (forearm)
- Responses to the Situational and Dispositional Pain Catastrophizing Scale
- Response to the State-Trait and Anxiety Inventory
- Response to the Beck's Depression Inventory
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 15 Years 至 —（Child, Adult, Older Adult）
- 性别
- Male
- 接受健康志愿者
- 否
入选标准
- •Elective minimally invasive surgical correction of funnel chest (pectus excavatum
- •age ≥15 years.
排除标准
- •Previous thoracic surgical interventions
- •Presence of diseases affecting the central and/or peripheral nervous system
- •Presence of chronic pain conditions
- •Inability to speak and/or understand Danish
- •Inability to understand and participate in the experimental pain session
- •Presence of psychiatric disorders
- •History of frostbite in the non-dominant upper limb
- •Presence of sores or cuts on non-dominant upper limb
- •Presence of cardiovascular disease
- •History of fainting and/or seizures
- •Presence of fractures of the non-dominant upper limb
- •Presence of Reynaud's phenomenon.
- •Secondary exclusions included:
- •Insensitivity to experimental cold pressor pain
- •Lack of epidural catheter placement
- •Re-operation
结局指标
主要结局
Postoperative pain unpleasantness
时间窗: Within the first 5 days after surgery
11-point (0-10) numerical rating scale of pain unpleasantness
Postoperative consumption of analgesics
时间窗: Within the first 5 days after surgery
The use of all pain-related treatments, including rescue analgesics and any other concomitant pain treatments.
Postoperative pain intensity
时间窗: Within the first 5 days after surgery
11-point (0-10) numerical rating scale of pain intensity
次要结局
未报告次要终点
研究者
Kasper Grosen
PhD
Aarhus University Hospital