TY - JOUR
T1 - Evaluating the Association Between Acute and Chronic Pain After Surgery
T2 - Impact of Pain Measurement Methods
AU - Gilron, Ian
AU - Vandenkerkhof, Elizabeth
AU - Katz, Joel
AU - Kehlet, Henrik
AU - Carley, Meg
PY - 2017
Y1 - 2017
N2 - AIM/OBJECTIVES/BACKGROUND: There is a need to predict chronic (Z3mo) postsurgical pain (CPSP). Acute (<7 d) pain is a predictor, that is, more severe pain is associated with higher CPSP risk. However, reported associations vary widely.METHODS: Using a systematic search, we examined associations between 2 acute pain measures (pain at rest [PAR] and movement-evoked pain [MEP]) and CPSP outcomes (considering severity vs. any "nonzero" pain only) in 22 studies.RESULTS: Seven studies reported the relationship between CPSP and both PAR and MEP. Of these, 2/7 reported no association, 3/7 reported significant associations for both PAR and MEP, 1/7 reported an association for PAR only, and 1/7 reported an association for MEP only. Six of another 7 studies reporting only the association for MEP found a significant relationship. Three of the 5 studies that did not specify whether acute pain outcomes were PAR or MEP reported a significant relationship. Another 3 studies reporting a relationship with CPSP did not specify whether this was for PAR, MEP, or both. All investigations incorporating severity of CPSP in their analyses (n=7) demonstrated a significant relationship, whereas only 10 of the 15 studies that dichotomized CPSP outcome as "no pain" versus "any"/"nonzero pain" were positive.CONCLUSIONS: Overall, evidence for an association between acute and chronic pain is moderate at best. However, closer attention to pain measurement methods will clarify the relationships between acute pain and CPSP. We propose that future CPSP predictor studies assess both PAR and MEP acutely and also incorporate CPSP severity in their analyses.
AB - AIM/OBJECTIVES/BACKGROUND: There is a need to predict chronic (Z3mo) postsurgical pain (CPSP). Acute (<7 d) pain is a predictor, that is, more severe pain is associated with higher CPSP risk. However, reported associations vary widely.METHODS: Using a systematic search, we examined associations between 2 acute pain measures (pain at rest [PAR] and movement-evoked pain [MEP]) and CPSP outcomes (considering severity vs. any "nonzero" pain only) in 22 studies.RESULTS: Seven studies reported the relationship between CPSP and both PAR and MEP. Of these, 2/7 reported no association, 3/7 reported significant associations for both PAR and MEP, 1/7 reported an association for PAR only, and 1/7 reported an association for MEP only. Six of another 7 studies reporting only the association for MEP found a significant relationship. Three of the 5 studies that did not specify whether acute pain outcomes were PAR or MEP reported a significant relationship. Another 3 studies reporting a relationship with CPSP did not specify whether this was for PAR, MEP, or both. All investigations incorporating severity of CPSP in their analyses (n=7) demonstrated a significant relationship, whereas only 10 of the 15 studies that dichotomized CPSP outcome as "no pain" versus "any"/"nonzero pain" were positive.CONCLUSIONS: Overall, evidence for an association between acute and chronic pain is moderate at best. However, closer attention to pain measurement methods will clarify the relationships between acute pain and CPSP. We propose that future CPSP predictor studies assess both PAR and MEP acutely and also incorporate CPSP severity in their analyses.
KW - Adult
KW - Aged
KW - Anesthetics/therapeutic use
KW - Antibiosis
KW - Attentional Bias
KW - Cognition/physiology
KW - Cohort Studies
KW - Emotions/physiology
KW - Female
KW - Humans
KW - Hysterectomy/adverse effects
KW - Middle Aged
KW - Pain Measurement/methods
KW - Pain, Postoperative/diagnosis
KW - Predictive Value of Tests
KW - Regression Analysis
U2 - 10.1097/AJP.0000000000000443
DO - 10.1097/AJP.0000000000000443
M3 - Journal article
C2 - 28145910
SN - 0749-8047
VL - 33
SP - 588
EP - 594
JO - Clinical Journal of Pain
JF - Clinical Journal of Pain
IS - 7
ER -