Characterisation of pragmatic postoperative PAin trajectories over seven days and their association with CHronicity after 3 months: a prospective, pilot cohort study (PATCH study)

2020 ◽  
pp. 100793
Author(s):  
Joël L’Hermite ◽  
M. Gabrielle Pagé ◽  
Thierry Chevallier ◽  
Bob Occean ◽  
Eric Viel ◽  
...  
Keyword(s):  
Cohort Study ◽  
Postoperative Pain ◽  
Pain Trajectories

scholarly journals Influential factors of postoperative pain trajectories in patients receiving intravenous patient-controlled analgesia: a single-centre cohort study in Taiwan

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031936 ◽  
Author(s):  
Ying-Hsuan Tai ◽  
Hsiang-Ling Wu ◽  
Shih-Pin Lin ◽  
Mei-Yung Tsou ◽  
Kuang-Yi Chang
Keyword(s):  
Cohort Study ◽  
Postoperative Pain ◽  
Abdominal Surgery ◽  
Influential Factors ◽  
Secondary Outcome ◽  
Patient Controlled Analgesia ◽  
Latent Curve ◽  
Latent Curve Models ◽  
Pain Trajectories ◽  
Complex Relationships

ObjectivesWe aimed to investigate the factors associated with variations in postoperative pain trajectories over time in patients using intravenous patient-controlled analgesia (IV-PCA) for postoperative pain.DesignRetrospective cohort study.SettingA single medical centre in Taiwan.ParticipantsPatients receiving IV-PCA after surgery.Primary and secondary outcome measuresPrimary outcome was the postoperative pain scores.ResultsA total of 3376 patients and 20 838 pain score observations were analysed using latent curve models. Female and longer anaesthesia time increased the baseline level of pain (p=0.004 and 0.003, respectively), but abdominal surgery and body weight decreased it (both p<0.001). Regarding the trend of pain resolution, lower abdominal surgery steepened the slope (p<0.001); older age, American Society of Anesthesiologists (ASA) class ≥3 and longer anaesthesia time tended to flatten the slope (p<0.001, =0.019 and <0.001, respectively). PCA settings did not affect the variations in postoperative pain trajectories.ConclusionsPatient demographics, ASA class, anaesthesia time and surgical sites worked together to affect postoperative pain trajectories in patients receiving IV-PCA. Latent curve models provided valuable information about the dynamic and complex relationships between the pain trajectories and their influential factors.

scholarly journals Evaluating the association of preoperative parecoxib with acute pain trajectories after video-assisted thoracoscopic surgery: a single-centre cohort study in Taiwan

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e038985
Author(s):  
Yu-Hsiang Ling ◽  
Ying-Hsuan Tai ◽  
Hsiang-Ling Wu ◽  
Wei-Lun Fu ◽  
Mei-Yung Tsou ◽  
...  
Keyword(s):  
Cohort Study ◽  
Postoperative Pain ◽  
Epidural Analgesia ◽  
Thoracoscopic Surgery ◽  
Curve Analysis ◽  
Pain Scores ◽  
Latent Curve ◽  
Pain Trajectories ◽  
Video Assisted Thoracoscopic Surgery ◽  
Over Time

ObjectiveThe efficacy of parecoxib as pre-emptive analgesia still remains controversial. This study aimed to investigate how pre-emptive analgesia with parecoxib affected postoperative pain trajectories over time in patients undergoing thoracic surgery.DesignRetrospective cohort study.SettingA single medical centre in Taiwan.ParticipantsWe collected 515 patients undergoing video-assisted thoracoscopic surgery at a tertiary medical centre between September 2016 and August 2017.InterventionsPre-emptive parecoxib before surgery.Primary and secondary outcome measuresDaily numeric rating pain scores in the first postoperative week.ResultsA total of 196 (38.1%) of the recruited patients received parecoxib preoperatively. The latent curve analysis revealed that woman, higher body weight and postoperative use of parecoxib were associated with increased baseline level of pain scores over time (p=0.035, 0.005 and 0.048, respectively) but epidural analgesia and preoperative use of parecoxib were inclined to decrease it (both p<0.001). Regarding the decreasing trends of changes in daily pain scores, older age and epidural analgesia tended to steepen the slope (p=0.014 and <0.001, respectively). Preoperative use of parecoxib were also related to decreased frequency of rescue morphine medication (HR=0.4; 95% CI 0.25 to 0.65).ConclusionsPre-emptive analgesia with parecoxib was associated with decreased baseline pain scores but had no connection with pain decreasing trends over time. Latent curve analysis provided insights into the dynamic relationships among the analgesic modalities, patient characteristics and postoperative pain trajectories.

scholarly journals Predictive Factors of Postoperative Pain and Postoperative Anxiety in Children Undergoing Elective Circumcision: A Prospective Cohort Study

2015 ◽  
Vol 28 (4) ◽  
pp. 244 ◽  
Author(s):  
Nick Zavras ◽  
Stella Tsamoudaki ◽  
Vasileia Ntomi ◽  
Ioannis Yiannopoulos ◽  
Efstratios Christianakis ◽  
...  
Keyword(s):  
Cohort Study ◽  
Postoperative Pain ◽  
Prospective Cohort Study ◽  
Predictive Factors ◽  
Prospective Cohort

scholarly journals Short-term outcomes of total knee arthroplasty performed with and without a tourniquet

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 15
Author(s):  
Mihai Grigoras ◽  
Oliver Boughton ◽  
May Cleary ◽  
Paul McKenna ◽  
Fiachra E. Rowan
Keyword(s):  
Total Knee Arthroplasty ◽  
Cohort Study ◽  
Postoperative Pain ◽  
Length Of Stay ◽  
Blood Loss ◽  
Retrospective Cohort ◽  
Thromboembolic Event ◽  
Short Term ◽  
Thromboembolic Risk ◽  
Total Knee

Introduction: Not using a tourniquet could improve early postoperative pain, range of motion (ROM), length of stay (LOS), and thromboembolic risk in patients undergoing total knee arthroplasty (TKA). Our aim was to compare these factors, intraoperative blood loss, and gender-related outcomes in patients undergoing primary TKA with or without a tourniquet. Methods: We performed a retrospective cohort study of 97 patients undergoing TKA with or without tourniquet from 2018 to 2020. Revisions and bilateral TKAs were excluded. Blood loss was estimated using a validated formula. Postoperative pain was tested using the visual analogue scale (VAS). ROM and quadriceps lag were assessed by a physiotherapist on a postoperative day 2 and discharge. The index of suspicion for a thromboembolic event was defined as the number of embolic-related investigations ordered in the first 6 months post-surgery. The Shapiro–Wilk test was used to assess the distribution of the data, Mann–Whitney for the continuous variables, and Fischer’s test for the categorical ones. Results and Discussion: There was a significant difference in blood loss. The non-tourniquet group lost on average 32% more blood (1291 mL vs. 878 mL, p<0.001 two-tailed). We found no difference in pain, ROM, LOS, and quadriceps lag on day 2 and at discharge. There was one thromboembolic event in the tourniquet group, but the thromboembolic index of suspicion did not differ (p=0.53). With tourniquet use, women had a significantly lower day 2 maximum flexion than men (71.56° vs. 84.67°, p=0.02). In this retrospective cohort study, the results suggest that tourniquet use is associated with lower blood loss and similar postoperative pain, range of motion, quadriceps lag, length of stay, and thromboembolic risk. There might be some differences between how men and women tolerate a tourniquet, with women having worse short-term outcomes compared to men.

scholarly journals O41 PREDICTORS OF LOW QUALITY AFTER OPEN INGUINAL HERNIA REPAIR USING THE EURAHS-QOL SCORE: PROSPECTIVE MULTICENTRIC COHORT STUDY

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Joana Simoes ◽  
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Fixation ◽  
Absorbable Mesh ◽  
Open Inguinal Hernia Repair

Abstract Aim Evidence about factors influencing quality of life after inguinal hernia surgery is scarce. This study aimed to identify predictors of low Quality of Life (QoL) after open inguinal hernia repair, to guide practice and inform patients at high risk. Material and Methods Prospective multicentric cohort study including consecutive patients undergoing elective open inguinal hernia repair in Portuguese hospitals (October-December 2019). The primary outcome was Quality of Life at 3 months after surgery, using the EuraHS-QoL score (higher score correlates with lower QoL). Low QoL was defined as the higher EuraHS-QoL score tertile and multivariate logistic regression was used to identify predictors. Results 893 patients were included from 33 hospitals. The majority were men (89.9% [800/891]), had unilateral hernias 88.7% (774/872) and the most common surgical technique was Lichtenstein’s repair (52.9% [472/893]). The median QoL score was 24 (IQR 10-40) before surgery and 2 (IQR 0-10) at 3 months after surgery, showing significant improvement (p &lt; 0.001). After adjustment, low QoL at 3 months was associated with low preoperative QoL (OR 1.76, 95% CI 1.21-2.57, p = 0.003), non-absorbable mesh fixation (OR 1.64, 95% CI 1.12-2.41, p = 0.011), severe immediate postoperative pain (OR 2.90, 95% CI 1.66-5.11, p &lt; 0.001) and minor postoperative complications (OR 2.23, 95% CI 1.30-3.84, p = 0.004). Conclusions This study supports the use of the EuraHS-QoL score preoperatively to inform consent. Although significant improvement in QoL is expected after surgery, high scores before surgery are associated with low postoperative QoL. Caution should be taken with non-absorbable mesh fixation and immediate postoperative pain control should be optimised.

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