The cumulative analgesic consumption score (CACS): evaluation of a new score to describe postsurgical analgesic consumption as a surrogate parameter for postoperative pain and invasiveness of surgical procedures

Schoenthaler, Martin; Miernik, Arkadiusz; Offner, Klaus; Karcz, Wojciech Konrad; Hauschke, Dieter; Sevcenco, Sabina; Kuehhas, Franklin E.; Bach, Christian; Buchholz, Noor; Wilhelm, Konrad

doi:10.1590/s1677-5538.ibju.2014.03.06

Cited by 11 publications

(10 citation statements)

References 29 publications

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“…For comparison, the CACS was used. This score is calculated by using a modified version of the WHO pain relief ladder [ 11 ]. Compared to other pain measurement scores, such as the NRS, CACS objectively describes analgesic consumption of an individual patient.…”

Section: Discussionmentioning

confidence: 99%

“…We observed lower CACS and therefore less pain in patients treated with PCA. PCA medication, however, was not included in the CACS calculation, described by Schoenthaler et al in their publication introducing the score [ 11 ]. To deal with this problem, we decided to calculate a modified MACS by using a ratio of total requests and successful demands.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, on the day of the operation, as well as on postoperative days one to three, CACS was calculated by analgesic medication treatment in all patients. The score is calculated by using the number of single analgesic doses multiplied by the level of the modified WHO pain relief ladder and finally added together [ 11 ]. In the PCA group, the score was calculated using the additional analgesic medication.…”

Section: Methodsmentioning

confidence: 99%

“…This score is not influenced by individual feelings but calculated using the number of demands and category of analgesic medication according to the WHO pain relief ladder. Previous studies showed correlations between CACS and NRS for discriminating invasiveness of surgical trauma by the magnitude of the score [ 11 ]. However, treatment with pain relief devices such as PCA is not considered in this calculation.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of pain relief sufficiency using the Cumulative Analgesic Consumption Score (CACS) and its modification (MACS)

Frank

Groene

Ehrlich-Treuenstätt

et al. 2017

wiitm

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Postoperative pain is one of the major complications in general and bariatric surgery, associated with ongoing problems such as ileus, pneumonia and prolonged mobilization. In this study, patients undergoing bariatric surgery were analyzed according to their postoperative pain relief regime. In one group patients were treated with a patient-controlled analgesia (PCA) device, while the other group was treated with oral and intravenous analgesic medication. The aim of this study was to analyze which postoperative pain relief therapy would be more appropriate. We chose the Cumulative Analgesic Consumption Score (CACS) and Numeric Rating Scale (NRS) for pain measurement. For better comparison, we performed a modification of CACS according to PCA treatment. We observed better pain relief in the PCA group. Furthermore, we observed an advantage of treatment with laxatives in patients treated with PCA. In conclusion, PCA devices are appropriate instruments for postoperative pain relief in bariatric patients. CACS is a practical tool for postoperative pain measurement, describing individual pain sensation more objectively, although holding further potential in modification.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of pain relief sufficiency using the Cumulative Analgesic Consumption Score (CACS) and its modification (MACS)

Frank

Groene

Ehrlich-Treuenstätt

et al. 2017

wiitm

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“…Analgesia consumption will be measured using the Cumulative Analgesia Consumption Scale (CACS) which measures both the quantity and potency of the analgesia based on WHO analgesia ladder over a 1 week period (56).…”

Section: General Outcomesmentioning

confidence: 99%

Collaborative Model of Care between Orthopaedics and Allied Healthcare Professionals in Knee Osteoarthritis (CONNACT): Study Protocol for an Effectiveness-Implementation Hybrid Randomized Control Trial

Tan¹,

PEREIRA²,

Su-Yin³

et al. 2020

Preprint

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Abstract Background: Knee Osteoarthritis (OA) is a leading cause of global disability, with most patients not receiving optimal non-surgical treatment resulting in significant morbidity and cost to the healthcare system, The Collaborative Model of Care between Orthopaedics and Allied Healthcare Professionals (CONNACT) Model of Care (MoC) was developed by optimizing evidence-based non-surgical treatments to deliver value-based care for people with knee OA. The primary aim of this study is to determine the clinical effectiveness of the CONNACT MoC compared to usual care. The secondary aims are: a) To determine the cost-effectiveness and b) To develop an evaluation and implementation framework to inform large scale implementation for this MoC. Design: A Type 1 Effectiveness-Implementation Hybrid Trial using an explanatory sequential mixed-method approach. Methodology: The study consists of 3 components. The first component is the pragmatic, parallel-arm, single-blinded randomized control trial. Inclusion criteria are patients with knee OA based on the National Institute of Health and Care Excellence (NICE) criteria with radiographic severity of greater than Kellgren-Lawrence 1, and Knee Injury and OA Outcome Score (KOOS4) of equal or less than 75. Exclusion criteria include other forms of arthritis, history of previous knee arthroplasty or wheelchair-bound patient. The intervention arm will undergo the CONNACT MoC while the usual care arm will be referred to the physiotherapist where the number and content of sessions are at the patient’s and physiotherapist’s discretion. The CONNACT MoC is a community-based, multidisciplinary 12-week program that uniquely uses an individualized approach based on a triaging criterion to tailor the treatment to each patient in line with the “right care, delivered at the right time, by the right team, in the right place, with the right resources” philosophy coupled with a strong emphasis on patient activation and self-management strategies to promote long term sustainable behavioural change. KOOS4 is the primary outcome measure. Secondary outcomes include KOOS individual subscales, quality of life scoring, functional performance, global, diet and psychological related outcomes. The second component is an economic evaluation of the cost-effectiveness of the CONNACT MoC using a societal perspective. The third component is an implementation and evaluation framework using process evaluation under the RE-AIM framework using a mixed-method approach. Discussion: A rapidly aging global population has resulted in an OA epidemic that is currently being poorly managed on a global scale. CONNACT MoC is a complex intervention that has been developed to meet this growing need. In line with the MRC guidance for developing and evaluating complex interventions, a pilot feasibility study was completed and a comprehensive approach including an RCT, economic evaluation and process evaluation is described in this study protocol. Results from this study will help clinicians, healthcare administrators and policymakers guide the sustainable and effective implementation of the CONNACT MoC for knee OA and serve as a basis for similar multidisciplinary MoC for chronic degenerative musculoskeletal conditions to be developed.Trial Registration: Clinicaltrials.gov Identifier: NCT03809975. Registered January 18 2019. https://clinicaltrials.gov/ct2/show/NCT03809975

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Ultra-mini PCNL versus flexible ureteroscopy: a matched analysis of analgesic consumption and treatment-related patient satisfaction in patients with renal stones 10–35 mm

et al. 2015

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Treatment of medium- to large-sized renal stones is safe and highly effective by both UMP and fURS. Moreover, both treatments yield comparable postsurgical analgesic requirements and high patient satisfaction scores. Patient-related factors (anatomical and stone related) and availability of technical equipment and surgical expertise appear to be the most important determining factors in treatment planning.

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The cumulative analgesic consumption score (CACS): evaluation of a new score to describe postsurgical analgesic consumption as a surrogate parameter for postoperative pain and invasiveness of surgical procedures

Cited by 11 publications

References 29 publications

Evaluation of pain relief sufficiency using the Cumulative Analgesic Consumption Score (CACS) and its modification (MACS)

Evaluation of pain relief sufficiency using the Cumulative Analgesic Consumption Score (CACS) and its modification (MACS)

Collaborative Model of Care between Orthopaedics and Allied Healthcare Professionals in Knee Osteoarthritis (CONNACT): Study Protocol for an Effectiveness-Implementation Hybrid Randomized Control Trial

Ultra-mini PCNL versus flexible ureteroscopy: a matched analysis of analgesic consumption and treatment-related patient satisfaction in patients with renal stones 10–35 mm

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