Acute pain trajectories and the persistence of post-surgical pain: a longitudinal study after total hip arthroplasty

Pagé, M. Gabrielle; Katz, Joel; Curtis, Kathryn; Lutzky-Cohen, Noga; Escobar, E. Manolo Romero; Clarke, Hance

doi:10.1007/s00540-016-2183-4

Cited by 40 publications

(72 citation statements)

References 43 publications

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Section: Discussionsupporting

confidence: 69%

“…Results from the acute pain trajectory model are strikingly similar to those obtained among patients undergoing total hip arthroplasty (Page et al., ), namely highlighting subgroups of patients with unchanging elevated or mild pain intensities as well as those with rapidly improving pain intensity. The literature is controversial regarding the association between acute post‐operative pain trajectories and CPSP outcomes (Althaus, Arranz Becker, & Neugebauer, ; Bonnet, Lavand'homme, France, Reding, & De Kock, ; Page et al., ). While acute post‐surgical pain, typically measured as a static variable, is a common risk factor for CPSP (Katz, ; Katz & Seltzer, ; Katz et al., ; Perkins & Kehlet, ; Schug & Bruce, ), the lack of such significant association in pain trajectory studies highlights the importance of examining the heterogeneity of pain responses acutely in the understanding and the prevention of CPSP.…”

Section: Discussionsupporting

confidence: 69%

“…Research suggests, however, that acute post-operative pain and opioid consumption are strongly associated (Lindberg et al, 2017;Maheshwari et al, 2016). Recently, studies have moved beyond simple static measures of acute pain to examine profiles of pain trajectories and how they relate to long-term outcomes (Chapman, Davis, Donaldson, Naylor, & Winchester, 2011;Chapman, Donaldson, Davis, & Bradshaw, 2011;Chapman, Fosnocht, & Donaldson, 2012;Page et al, 2016). It remains to be determined whether specific empirically derived opioid consumption profiles following surgery might contribute to the prediction of CPSP above and beyond pain intensity.…”

Section: Introductionmentioning

confidence: 99%

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In‐hospital opioid consumption, but not pain intensity scores, predicts 6‐month levels of pain catastrophizing following hepatic resection: A trajectory analysis

Pagé

Karanicolas

Cleary

et al. 2018

European Journal of Pain

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Background The study aims were to model acute pain intensity and opioid consumption trajectories up to 72 hr after open hepatic resection, identify predictors of trajectory membership and examine the association between trajectory memberships and 6‐month pain and psychological outcomes. This is a long‐term analysis of a published randomized controlled trial on the impact of medial open transversus abdominis plane catheters on post‐operative outcomes. Methods A total of 152 patients (89 males; mean age 63.0 [range: 54–72]) completed questionnaires on pain and related characteristics pre‐operatively and 6 months post‐operatively. Total opioid use was recorded several times over a 72‐hr period while self‐reported pain intensity scores were collected multiple times until hospital discharge. Analyses were carried out using growth mixture modelling, logistic regression and general linear models. Results Both pain intensity and opioid consumption showed that a four‐trajectory model best fits the data. Patients in the lowest opioid consumption trajectory were more likely to be classified in the constant mild pain intensity trajectory. Age and baseline levels of anxiety significantly predicted opioid trajectory membership while baseline depressive symptoms significantly predicted pain intensity trajectory membership. Patients in the two highest opioid consumption trajectories reported significantly higher levels of pain catastrophizing at 6 months compared to patients in the other 3 trajectories (all p < 0.05). Conclusion High consumption of opioids after surgery is associated with higher levels of pain catastrophizing 6 months later. Identification of patients within these trajectories may lead to the development of early interventions targeted to high risk individuals. Significance Differences in initial levels of opioid consumption and rates of change in opioid consumption shortly after surgery can help predict long‐term psychological responses to pain. Identifying key characteristics associated with initial opioid consumption can lead to the development of cost‐effective early interventions targeted to high risk individuals.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

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In‐hospital opioid consumption, but not pain intensity scores, predicts 6‐month levels of pain catastrophizing following hepatic resection: A trajectory analysis

Pagé

Karanicolas

Cleary

et al. 2018

European Journal of Pain

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“…ese probabilistic latent class models can capture the progressive change of pain over time [10] that is unique to specific subgroups of individuals. In adults after total hip arthroplasty, Pagé et al (2016) identified 4 pain trajectories in the acute postoperative period [11]. Importantly, preoperative variables such as pain and anxiety predicted pain trajectory membership.…”

Section: Introductionmentioning

confidence: 99%

Predicting Acute Postoperative Pain Trajectories and Long-Term Outcomes of Adolescents after Spinal Fusion Surgery

Ocay

Ingelmo

et al. 2020

Pain Research and Management

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Objectives. Acute pain trajectories are associated with long-term outcomes such as persistent pain and functional disability in adults. However, there are limited data on acute postoperative pain trajectories in the pediatric population. The aims of this study were to investigate acute postoperative pain trajectories, their predictors, and their impact on long- term outcomes in adolescents with idiopathic scoliosis. Methods. We evaluated the preoperative pain intensity, use of analgesics, psychosocial measures and physical functioning of adolescents scheduled to undergo spinal fusion, and their average 6-hour self-reported pain intensity scores for their entire hospital stay. Six months after surgery, baseline variables were reassessed. We used growth mixture modeling to conduct acute postoperative pain trajectory analysis and to identify predictors of pain trajectories. Generalized linear models were conducted to determine whether acute pain trajectories predict long-term outcomes. Results. One hundred and six patients were included in the best-fitted acute pain trajectory model that included four classes that differed in initial pain intensity and rates of change over time. Preoperative pain catastrophizer status and use of analgesics significantly predicted pain trajectory membership. Furthermore, at the 6-month follow-up, patients experiencing moderate-to-severe pain in the acute postoperative period were more likely to report higher levels of pain severity, use pain medication, and miss a greater number of school/work days due to back pain in the last three months. Discussion. Preoperative assessment and analyzing the progression of pain in the acute postoperative period can help identify those at risk of negative long-term outcomes after surgery.

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“…Among the three (mild, moderate and severe pain) clusters, patients with a severe pain trajectory turned out to have a high risk of chronic pain 6 months after the surgery. A similar approach has been attempted following total hip arthroplasty, by evaluating a GBTM-based acute pain trajectory for 5 days after the surgery, although it failed to predict future chronic pain [18]. It seems that information on pain intensity for approximately 7 days after surgery has substantially contributed to the accuracy of prediction of the likelihood of development of chronic postsurgical pain.…”

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confidence: 99%

A good beginning makes a good ending: association between acute pain trajectory and chronic postsurgical pain

Amaya

2018

J Anesth

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Acute pain trajectories and the persistence of post-surgical pain: a longitudinal study after total hip arthroplasty

Cited by 40 publications

References 43 publications

In‐hospital opioid consumption, but not pain intensity scores, predicts 6‐month levels of pain catastrophizing following hepatic resection: A trajectory analysis

In‐hospital opioid consumption, but not pain intensity scores, predicts 6‐month levels of pain catastrophizing following hepatic resection: A trajectory analysis

Predicting Acute Postoperative Pain Trajectories and Long-Term Outcomes of Adolescents after Spinal Fusion Surgery

A good beginning makes a good ending: association between acute pain trajectory and chronic postsurgical pain

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