Pre-emptive and preventive NSAIDs for postoperative pain in adults undergoing all types of surgery

Doleman, Brett; Leonardi‐Bee, Jo; Heinink, Thomas P; Lund, Jonathan N.; Williams, John P.

doi:10.1002/14651858.cd012978.pub2

Cited by 60 publications

(28 citation statements)

References 119 publications

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“…Second, we only tested the analgesic effects of subcutaneously injected diclofenac and buprenorphine as examples of analgesics commonly used worldwide in perioperative clinical settings. 24 The ability to capture the effects of weak analgesics, such as diclofenac, indicates the high sensitivity of DWB for evaluating the analgesic potency of target drugs. However, changes in DWB-derived parameters may differ for other types of analgesics (eg, opioids, local anesthetics, and anti-depressants) or delivery routes (eg, intravenous, enteral, and spinal).…”

Section: Discussionmentioning

confidence: 99%

“…Third, the current study only tested preemptively administered analgesics in our mouse models, given that preemptive analgesia is a common practice in anesthetic managements for better control of postoperative pain. 24–26 However, the ability of DWB to sensitively capture the therapeutic effects of analgesics administered solely after the establishment of postoperative pain remains unclear. Information extracted from DWB analyses in the current study only included the weight loaded on the ipsilateral hind paw and pawprint area on the ipsilateral and contralateral hind paws.…”

Section: Discussionmentioning

confidence: 99%

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Objective and Quantitative Evaluation of Spontaneous Pain-Like Behaviors Using Dynamic Weight-Bearing System in Mouse Models of Postsurgical Pain

Lu¹,

Kato²,

Toramaru³

et al. 2022

JPR

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Background The paucity of objective and reliable measurements of pain-like behaviors has impeded the translatability of mouse models of postsurgical pain. The advanced dynamic weight-bearing (DWB) system enables evaluation of spontaneous pain-like behaviors in pain models. This study investigated the suitability and efficiency of the DWB system for assessing spontaneous pain-like behaviors and analgesic therapies in murine models of postsurgical pain. Methods Male adult C57BL/6JJcl mice were subjected to multiple surgical pain models with distinct levels of invasiveness, including a superficial incisional pain model involving only hind paw skin incision, deep incisional pain model that also involved incision and elevation of the underlying hind paw muscles, and orthopedic pain model involving tibial bone fracture and fixation with a pin (fracture and pinning [F/P] model). Spontaneous pain-like behaviors post-surgery were evaluated using weight distribution, pawprint area of the operated paw in the DWB system, and guarding pain score. Mechanical hypersensitivity was assessed using the von Frey test. The therapeutic effects of analgesics (diclofenac and buprenorphine for the deep incision model and diclofenac for the F/P model) were evaluated using the DWB system and von Frey test. Results The von Frey test demonstrated contradictory results between superficial and deep incisional pain models. The DWB system captured weight distribution changes in the operated hind paw, in accordance with the invasiveness and time course of wound healing in these surgical pain models. The reduction in weight-bearing on the operated paw correlated with guarding score, degree of paw swelling, and local expression of inflammatory mediators. DWB enabled accurate evaluation of the pharmacological effects of analgesics for detecting attenuation of surgery-induced weight-bearing changes in these models. Conclusion The DWB system serves as an objective and reliable method for quantifying pain-like behaviors and evaluating the therapeutic effects of analgesics in mouse models of postsurgical pain models.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Objective and Quantitative Evaluation of Spontaneous Pain-Like Behaviors Using Dynamic Weight-Bearing System in Mouse Models of Postsurgical Pain

Lu¹,

Kato²,

Toramaru³

et al. 2022

JPR

View full text Add to dashboard Cite

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“…In the available literature, the recommended minimal clinically important difference of analgesic consumption for postoperative pain control is an absolute reduction of 10 mg i.v. morphine in 24 h (Doleman et al, 2021). Because of this design limitation, an issue that cannot be answered by this study is whether three analgesic techniques have resulted in different post-operative opioid-sparing effects, an important outcome endpoint of the Enhanced Recovery After Surgery protocols (Rajput et al, 2022).…”

Section: Comment On 'Impact Of Analgesic Techniques On Early Quality ...mentioning

confidence: 91%

Comment on ‘Impact of analgesic techniques on early quality of recovery after prostatectomy: A 3‐arm, randomized trial’ by Beilstein and colleagues

Jiang

Xue

et al. 2023

European Journal of Pain

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“…Sample size was determined to assess the precision of the estimated mean score of pain level, measured by the BPI (Kean et al 2016), using a 11-point NRS (0 = no pain and 10 = worst pain). Specifically, we determined n = 25 patients per treatment condition such that the 95% confidence interval (CI) for the mean score for each treatment condition was within the ±1.5 (Doleman et al 2021) range, assuming the standard deviation of the pain levels was 3.6 (Chang et al 2017) or less. Sample size was also based upon a minimum number of participants considered sufficient for user testing of OARS procedures and technology systems.…”

Section: Methodsmentioning

confidence: 99%

The Opioid Analgesic Reduction Study (OARS) Pilot: A Double-Blind Randomized Multicenter Trial

Feldman

Fredericks-Younger

Desjardins

et al. 2023

JDR Clinical & Translational Research

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Background: With addiction rates and opioid deaths increasing, health care providers are obligated to help stem the opioid crisis. As limited studies examine the comparative effectiveness of fixed-dose combination nonopioid analgesia to opioid-containing analgesia, a comparative effectiveness study was planned and refined by conducting a pilot study. Methods: The Opioid Analgesic Reduction Study (OARS) pilot, a stratified, randomized, multisite, double-blind clinical trial, was designed to test technology and procedures to be used in the full OARS trial. Participants engaged in the full protocol, enabling the collection of OARS outcome data. Eligible participants reporting to 1 of 5 sites for partial or full bony impacted mandibular third molar extraction were stratified by biologic sex and randomized to 1 of 2 treatment groups, OPIOID or NONOPIOID. OPIOID participants were provided 20 doses of hydrocodone 5 mg/acetaminophen 300 mg. NONOPIOID participants were provided 20 doses of ibuprofen 400 mg/acetaminophen 500 mg. OARS outcomes data, including pain experience, adverse effects, sleep quality, pain interference, overall satisfaction, and remaining opioid tablets available for diversion, were collected via surveys, electronic medication bottles, eDiary, and activity/sleep monitor. Results: Fifty-three participants were randomized with 50 completing the OARS pilot protocol. Across all outcome pain domains, in all but 1 time period, NONOPIOID was better in managing pain than OPIOID ( P < 0.05 level). Other outcomes suggest less pain interference, less adverse events, better sleep quality, better overall satisfaction, and fewer opioid-containing tablets available for diversion. Discussion: Results suggest patients requiring impacted mandibular third molar extraction would benefit from fixed-dose combination nonopioid analgesia. Knowledge Transfer Statement: Study results suggest fixed-dose nonopioid combination ibuprofen 400 mg/acetaminophen 500 mg is superior to opioid-containing analgesic (hydrocodone 5 mg/acetaminophen 500 mg). This knowledge should inform surgeons and patients in the selection of postsurgical analgesia.

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Pre-emptive and preventive NSAIDs for postoperative pain in adults undergoing all types of surgery

Abstract: Pre-emptive and preventive NSAIDs for postoperative pain in adults undergoing all types of surgery (Review)

Cited by 60 publications

References 119 publications

Objective and Quantitative Evaluation of Spontaneous Pain-Like Behaviors Using Dynamic Weight-Bearing System in Mouse Models of Postsurgical Pain

Objective and Quantitative Evaluation of Spontaneous Pain-Like Behaviors Using Dynamic Weight-Bearing System in Mouse Models of Postsurgical Pain

Comment on ‘Impact of analgesic techniques on early quality of recovery after prostatectomy: A 3‐arm, randomized trial’ by Beilstein and colleagues

The Opioid Analgesic Reduction Study (OARS) Pilot: A Double-Blind Randomized Multicenter Trial

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