Postoperative Pain Trajectories in Cardiac Surgery Patients

Chapman, C. Richard; Zaslansky, Ruth; Donaldson, Gary; Shinfeld, Amihay

doi:10.1155/2012/608359

Cited by 31 publications

(33 citation statements)

References 58 publications

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“…The results of the two domains (pain and energy level) analyzed show the functional improvement described by the FIM on the patients form the VRG on the 1 st POD, because it is known that pain limits functional recovery [39].…”

Section: Cg Thus Showing Significant Difference On Thementioning

confidence: 91%

The use of the virtual reality as intervention tool in the postoperative of cardiac surgery

Cacau¹,

Oliveira²,

Maynard³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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Veja reportagem sobre o tema desenvolvido neste artigo acessando o link: http://globotv.globo.com/tv-sergipe/se-tv-2a-edicao/v/games-sao-terapiapara-pacientes-cardiacos-em-aracaju/2194856/ EXPERIMENTAL STUDY Abstract Introduction: Cardiac surgery has been the intervention of choice in many cases of cardiovascular diseases. Susceptibility to postoperative complications, cardiac rehabilitation is indicated. Therapeutic resources, such as virtual reality has been helping the rehabilitational process. The aim of the study was to evaluate the use of virtual reality in the functional rehabilitation of patients in the postoperative period.Methods: Patients were randomized into two groups, Virtual Reality (VRG, n = 30) and Control (CG, n = 30). The response to treatment was assessed through the functional independence measure (FIM), by the 6-minute walk test (6MWT) and the Nottingham Health Profile (NHP). Evaluations were performed preoperatively and postoperatively.Results: On the first day after surgery, patients in both groups showed decreased functional performance. However, the VRG showed lower reduction (45.7±2.3) when compared to CG (35.06±2.09, P<0.05) in first postoperative day, and no significant difference in performance on discharge day (P>0.05). In evaluating the NHP field, we observed a significant decrease in pain score at third assessment (P<0.05). These patients also had a higher energy level in the first evaluation (P<0.05). There were no differences with statistical significance for emotional reactions, physical ability, and social interaction. The length of stay was significantly shorter in patients of VRG (9.4±0.5 days vs. 12.2 ± 0.9 days, P<0.05), which also had a higher 6MWD 282Rev Bras Cir Cardiovasc | Braz J Cardiovasc Surg Bras Cir Cardiovasc 2013;28(2):281-9 Rev

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Section: Cg Thus Showing Significant Difference On Thementioning

confidence: 91%

The use of the virtual reality as intervention tool in the postoperative of cardiac surgery

Cacau¹,

Oliveira²,

Maynard³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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“…14 Similar results were obtained in a sample of adults undergoing cardiac surgery. 16 Another study of pain trajectories of liver donor patients showed that patients who developed CPSP had higher pain intensity trajectories in the first 24 hours after surgery or an abnormal resolution of their acute pain. 10 The goals of this study were to: (1) identify and describe the various pain trajectories beginning preoperatively and for up to 12 months after surgery, (2) identify baseline predictors of trajectory group membership, and (3) identify trajectory groups that are associated with poor psychosocial outcomes 12 months after surgery in a cohort of patients undergoing TKA.…”

Section: Introductionmentioning

confidence: 99%

Distinguishing problematic from nonproblematic postsurgical pain

Pagé

Katz

Escobar

et al. 2015

Pain

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The goal of this study was to follow a cohort of patients undergoing total knee arthroplasty over time to: (1) identify and describe the various pain trajectories beginning preoperatively and for up to 12 months after surgery, (2) identify baseline predictors of trajectory group membership, and (3) identify trajectory groups associated with poor psychosocial outcomes 12 months after surgery. One hundred seventy-three participants (female = 85 [49%]; mean age [years] = 62.9, SD = 6.8) completed pain and psychological questionnaires and functional performance tests preoperatively and 4 days, 6 weeks, and 3 and 12 months after total knee arthroplasty. Using growth mixture modeling, results showed that a 4-group model, with a quadratic slope and baseline pain data predicting trajectory group membership, best fit the data (Akaike information criterion = 2772.27). The first 3 pain trajectories represent various rates of recovery ending with relatively low levels of pain 12 months after surgery. Group 4, the constant high pain group, comprises patients who have a neutral or positive pain slope and do not show improvement in their pain experience over the first year after surgery. This model suggests that preoperative pain levels are predictive of pain trajectory group membership and moderate preoperative pain, as opposed to low or high pain, is a risk factor for a neutral or positive pain trajectory postoperatively. Consistent with previous studies, these results show that postoperative pain is not a homogeneous condition and point to the importance of examining intraindividual pain fluctuations as they relate to pain interventions and prevention strategies.

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“…Linear growth curve modeling is appropriate for use in developing postoperative pain trajectories [10][11][12][13][14]. Repeated measures of pain yield better precision.…”

Section: Discussionmentioning

confidence: 99%

“…The concept of pain trajectory suggests that the slope of the trajectory and not one daily score should be the target of pain control intervention [14]. There are no studies on pain trajectories specifically in trauma patients.…”

Section: Special Issue: Anesthesia and Critical Carementioning

confidence: 99%

Acute Longitudinal Pain Trajectories in the Traumatically Injured

Trevino¹

2015

SOJAPM

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The purpose of this study was to determine if in-hospital pain trajectories exist and if certain pain trajectories predict the development of pain in 101 participants at four months post-trauma. The growth mixture model analysis suggested the presence of 5 latent classes, with observed and predicted trajectories. It appears that patients in classes 1 (low initial pain) and 3 (high initial pain dropping fast and staying low) tend to have less pain at 4 months, while patients in Class 5 (high initial pain dropping fast, but rebounding) tend to have more pain at 4 months. This study did not provide definitive evidence that the trajectory of in-hospital pain predicts the development of chronic pain. Unfortunately, the latent slope did not predict pain scores at four months. However, it was found that probability of developing chronic pain measured by the numeric pain score (NPS 0-3=no chronic pain, NPS 4-10=chronic pain) with a discharge NPS of 0-2 is 0.06, 2-4 is 0.29, 4-6 is 0.35, 6-8 is 0.50 and 8-10 are 0.80. Pain must be controlled in the hospital to prevent the development of chronic pain out of the hospital. Clinicians can identify those at risk by reviewing their average pain scores on the day of discharge.Perspective: This manuscript addresses the issues of pain trajectories that have been previously published in the Journal of Pain. However, this study applied the previously published ideas to the longitudinal development of chronic pain. This is a novel attempt at determining pain trajectories and their relationship to the development of chronic pain.

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Postoperative Pain Trajectories in Cardiac Surgery Patients

Cited by 31 publications

References 58 publications

The use of the virtual reality as intervention tool in the postoperative of cardiac surgery

The use of the virtual reality as intervention tool in the postoperative of cardiac surgery

Distinguishing problematic from nonproblematic postsurgical pain

Acute Longitudinal Pain Trajectories in the Traumatically Injured

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