Pain predict genetics: protocol for a prospective observational study of clinical and genetic factors to predict the development of postoperative pain

Abstract

IntroductionPostoperative pain remains a challenging medical condition impacting the quality of life of every patient. Although several predictive factors for postoperative pain have been identified, an adequate prediction of postoperative pain in patients at risk has not been achieved yet.The primary objective of this study is to identify specific genetic risk factors for the development of acute and chronic postoperative pain to construct a prediction model facilitating a more personalised postoperative pain management for each individual. The secondary objectives are to build a databank enabling researchers to identify other risk factors for postoperative pain, for instance, demographic and clinical outcome indicators; provide insight into (genetic) factors that predict pharmacological pain relief; investigate the relationship between acute and chronic postoperative pain.Methods and analysisIn this prospective, observational study, patients who undergo elective surgery will be recruited to a sample size of approximately 10 000 patients. Postoperative acute and chronic pain outcomes will be collected through questionnaires at different time points after surgery in the follow-up of 6 months. Potential genetic, demographic and clinical risk factors for prediction model construction will be collected through blood, questionnaires and electronic health records, respectively.Genetic factors associated with acute and/or chronic postoperative pain will be identified using a genome-wide association analysis. Clinical risk factors as stated in the secondary objectives will be assessed by multivariable regression. A clinical easy-to-use prediction model will be created for postoperative pain to allow clinical use for the stratification of patients.Ethics and disseminationThe Institutional Review Board of the Radboud university medical centre approved the study (authorisation number: 2012/117). The results of this study will be made available through peer-reviewed scientific journals and presentations at relevant conferences, which will finally contribute to personalised postoperative pain management.Trial registration numberNCT02383342.

The mechanisms and management of persistent postsurgical pain

“…Thus, there is a need for large-scale, homogeneous, replication studies to validate candidate genes and recognise the fundamental biological networks for underpinning PPP. One study that is expected to finish in 2025 combines several outcome measures in a large cohort (10,000 patients) and will enable stratification for patients based on pain outcomes using genetic, demographic and clinical factor prediction models ( 52 ).…”