Development and validation of a multivariable prediction model for early prediction of chronic postsurgical pain in adults: a prospective cohort study

Driel, Marjelle E C van; Dijk, Jacqueline F.M. van; Baart, Sara J.; Meißner, Winfried; Huygen, Frank; Rijsdijk, Mienke

doi:10.1016/j.bja.2022.04.030

Cited by 34 publications

(34 citation statements)

References 39 publications

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“…The final model included four predictors: preoperative opioid use, bone surgery, pain score on postoperative day 14, and the presence of a painful cold within the painful area 2 weeks after surgery, with a reported area under the curve of 0.82. The neuropathic characteristics of pain were shown to be strong predictors of CPSP development in this model, supporting the neuropathic mechanism with nervous system sensitization [52]. In addition to the development of a more accurate prediction model for CPSP, future research is needed to determine whether CPSP can be reduced when the prediction model is used in clinical practice.…”

Section: ) Risk Prediction Modelmentioning

confidence: 58%

“…Since this model contains a postoperative factor, preoperative screening with this predictive model is not possible. Recently, a predictive model was developed and validated in a prospective cohort of patients undergoing orthopedic, vascular, trauma, and general surgery [52]. The final model included four predictors: preoperative opioid use, bone surgery, pain score on postoperative day 14, and the presence of a painful cold within the painful area 2 weeks after surgery, with a reported area under the curve of 0.82.…”

Section: ) Risk Prediction Modelmentioning

confidence: 99%

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Practical strategies for the prevention and management of chronic postsurgical pain

2023

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Chronic postsurgical pain (CPSP) is a multifactorial condition that affects a significant proportion of patients undergoing surgery. The prevention and management of CPSP require the identification of preoperative risk factors to screen high-risk patients and establish appropriate perioperative pain management plans to prevent its development. Active postoperative pain management should be provided to prevent CPSP in patients with severe pain following surgery. These tasks have become important for perioperative team members in the management of CPSP. This review article provides a comprehensive overview of the latest research on the role of perioperative team members in preventing and managing CPSP. Additionally, it highlights practical strategies that can be employed in clinical practice, covering the definition and risk factors for CPSP, including preoperative, intraoperative, and postoperative factors, as well as a risk prediction model. The article also explores various treatments for CPSP, as well as preventive measures, including preemptive analgesia, regional anesthesia, pharmacological interventions, psychoeducational support, and surgical technique modification. This article emphasizes the importance of a comprehensive perioperative pain management plan that includes multidisciplinary interventions, using the transitional pain service as an example. By adopting a multidisciplinary and collaborative approach, perioperative team members can improve patient outcomes, enhance patient satisfaction, and reduce healthcare costs. However, further research is necessary to establish targeted interventions to effectively prevent and manage CPSP.

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Section: ) Risk Prediction Modelmentioning

confidence: 58%

Section: ) Risk Prediction Modelmentioning

confidence: 99%

Practical strategies for the prevention and management of chronic postsurgical pain

2023

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“…The recent model of van Driel et al 36 however suffers some limitations including the fact that psychological factors were not not taken into account. Psychological vulnerability has been incriminated in the risk to present with severe acute postoperative pain and to develop CPSP.…”

Section: First Progress About Cpsp: a Common Definition And Its Recog...mentioning

confidence: 99%

“…Despite the value of subacute pain as a risk factor for the development of CPSP (demonstrated in various surgical procedures like inguinal hernia repair 32,33 , orthopedic surgery 34 …), pain after hospital discharge is rarely included in the predictive models of CPSP 26 35. A very recent publication by Van Driel et al reports the development and validation of a new prediction model for the early prediction of CPSP after major surgical procedures 36 . The model (N=344 for its development; N=150 for its validation) is based on four easily obtainable predictors in clinical practice and thereby could alert health care providers to further assess and treat the Perioperative risk factors involved in the development of CPSP according to published narrative reviews (Schug & Bruce) 24 , sytematic reviews (Papadomanolakis-Pakis et al, Giusti et al) 26,39 and prospective studies (Montes et al, van Driel et al) 23,36 .…”

Section: First Progress About Cpsp: a Common Definition And Its Recog...mentioning

confidence: 99%

“…A very recent publication by Van Driel et al reports the development and validation of a new prediction model for the early prediction of CPSP after major surgical procedures 36 . The model (N=344 for its development; N=150 for its validation) is based on four easily obtainable predictors in clinical practice and thereby could alert health care providers to further assess and treat the Perioperative risk factors involved in the development of CPSP according to published narrative reviews (Schug & Bruce) 24 , sytematic reviews (Papadomanolakis-Pakis et al, Giusti et al) 26,39 and prospective studies (Montes et al, van Driel et al) 23,36 . In bold: major risk factors currently known (all being clinical risk factors).…”

Section: First Progress About Cpsp: a Common Definition And Its Recog...mentioning

confidence: 99%

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Chronic pain after surgery and trauma: current situation and future directions

Lavand’homme¹

2022

Acta Anaest Belg

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Chronic post-surgical pain (CPSP) stands as a major health issue. The unchanged incidence over the last two decades underlines both the failure of predictive models developed until now and the lack of efficacy of common “preventive” strategies (pharmacotherapy and regional analgesic techniques) applied in current clinical practice. The recognition of CPSP as a disease and the release of a common definition of the condition is an important progress in the field. CPSP predictive scores exist but none has presently demonstrated an impact on patient care. New clinical directions based on the resolution of postoperative pain, a complex and highly dynamic process supported by individual pain trajectories, argue for predictive models and preventive strategies extended to the subacute pain period i.e. after hospital discharge.

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Liposomal bupivacaine for ultrasound‐guided rectus sheath blocks after midline laparotomy

Vereen,

Harms,

Stolker

et al. 2024

Anaesthesia Reports

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SummaryOptimal pain management after open abdominal surgery is essential but can be difficult to achieve. The effects of inadequate analgesia go beyond the first few postoperative days; severe acute postoperative pain may contribute to the development of chronic postsurgical pain. Thoracic epidural analgesia is a traditional approach to the management of acute pain after open abdominal surgery but has multiple possible contraindications and can be technically challenging. In our hospital, we typically offer ultrasound‐guided rectus sheath blocks with catheters when epidural analgesia is not feasible. However, the recent registration of long‐acting liposomal bupivacaine in the Netherlands as well as logistical and equipment‐related issues have led us to consider liposomal bupivacaine as an alternative to the use of catheters. Here, we present a short case series to describe our first clinical experiences with the use of liposomal bupivacaine in ultrasound‐guided rectus sheath blocks after midline laparotomy for three patients in whom epidural insertion was contraindicated.

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Development and validation of a multivariable prediction model for early prediction of chronic postsurgical pain in adults: a prospective cohort study

Cited by 34 publications

References 39 publications

Practical strategies for the prevention and management of chronic postsurgical pain

Practical strategies for the prevention and management of chronic postsurgical pain

Chronic pain after surgery and trauma: current situation and future directions

Liposomal bupivacaine for ultrasound‐guided rectus sheath blocks after midline laparotomy

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