Following surgery, some but not all patients develop persistent (or chronic) postoperative pain CPSP. Several risk factors for this persistent pain have been confirmed in previous studies, but neither surgeons nor anesthesiologists have or take the time to systematically screen patients for this risk. However, hospital information systems often contain the data already, entered during preoperative consultations (e.g. chronic opioid medication) or obtained during the postoperative period (e.g. pain scores). Here the investigators test an automatic detection algorithm which alerts the analgesia team when a patient at risk of CPSP is or has been operated.
The primary aim of the study is to confirm that the sensitivity of the automatic alert is at least 80%, i.e. that 80% of patients with the primary outcome had an automatic alert. The secondary aim of the study is to develop an algorithm (combination of risk factors) with which the specificity of the alert can be improved.
Study Type
OBSERVATIONAL
Enrollment
355
automatic alert of the risk for CPSP, triggered by one of the following entries in the hospital information system: psychological risk factors (depression, anxiety, PTSD, catastrophizing, high pain anticipation), chronic use of benzodiazepines or opioids, intense postoperative pain or need of large opioid doses in the recovery room
Hôpitaux Universitaires de Genève
Geneva, Switzerland
CPSP at 6 months
mean pain intensity in the "brief pain inventory" of at least 3/10
Time frame: 6 months
CPSP at 12 months
mean pain intensity in the "brief pain inventory" of at least 3/10
Time frame: 12 months
clinically significant pain at 6/12 months
either a pain intensity of \>=3 at rest or \>=5 on movement or use of analgesics
Time frame: 6/12 months
neuropathic pain at 6/12 months
mean pain intensity in the "brief pain inventory" of at least 3/10 AND a DN4 score of at least 4
Time frame: 6/12 months
acute postoperative pain
mean pain score and highest pain score in the first 24h postoperative on a 0-10 verbal numeric rating scale
Time frame: 24h postoperative
pain-related functional deficit at 6/12 months
pain interference scales of the brief pain inventory, number of days not working
Time frame: 6/12 months
persistent opioid use
patient reported use of tramadol (yes/no) or use of strong opioids (yes/no)
Time frame: 6/12 months
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