A Prospective Cohort Study of Acute Pain and In-Hospital Opioid Consumption After Cardiac Surgery: Associations With Psychological and Medical Factors and Chronic Postsurgical Pain
Authors' conclusion
Those with moderate pain intensity right after surgery are more likely to develop CPSP suggesting that those patients should be flagged early on in their postoperative recovery to attempt to alter their trajectory and prevent CPSP.
Study context
- Population
- Adults undergoing cardiac surgery recruited from the preoperative clinic, August 2012 to June 2020959 analysed
- Participants
- 1,115 adults
- Exposure
- Acute pain intensity and opioid consumption trajectories after cardiac surgery
- Initially moderate pain intensity remaining moderaten = 62reference
- Initially mild pain intensity remaining mildn = 221
- Initially moderate pain intensity decreasing to mildn = 251
- Initially high level of MME/day gradually decreasingn = 89
- Initially low level of MME/day remaining lown = 108
- Initially moderate level of MME/day decreasing to lown = 329
- Outcome
- Pain intensity scores and MME/day consumption trajectories (latent growth mixture modeling (GMM))
- Follow-up
- First 6 PODs
Methodological detailsobservational, latent growth mixture modeling
- Observational
- Latent growth mixture modeling
Main finding
As reported in the abstract
Acute pain intensity and opioid consumption trajectories
- Three distinct linear acute postoperative pain intensity trajectories identified
- Age, sex, emotional distress in response to bodily sensations and sensitivity to pain traumatization significantly associated with pain intensity trajectories
- Three distinct opioid consumption trajectories identified on log MME/day
- Age and emotional distress in response to bodily sensations associated with opioid trajectory membership
Observational data: associations, not effects.
Secondary outcomes
| Outcome | OR (95% CI) | |
|---|---|---|
| CPSP by pain intensity trajectory · 12 monthsInitially mild pain intensity remaining mild vs initially moderate pain intensity remaining moderate | 0.23 (0.06–0.88) | |
| 0.050.21520Odds ratio (log scale) |
Chronic postsurgical pain (CPSP) by opioid consumption trajectory · 12 months
| OR (95% CI) | ||
|---|---|---|
| Opioid consumption trajectory | 0.84 (0.28–2.54) | |
| Opioid consumption trajectory | 0.95 (0.22–4.13) | |
| 0.20.5125Odds ratio (log scale) |
- CPSP by pain intensity trajectory: 573 completed 1-year follow-up
Original publication
A Prospective Cohort Study of Acute Pain and In-Hospital Opioid Consumption After Cardiac Surgery: Associations With Psychological and Medical Factors and Chronic Postsurgical Pain. Anesth Analg. Published 31 January 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →