Evaluation of Pain Trajectories After Surgery and Their Potential Relationship With Chronicity at 3 Months

Centre Hospitalier Universitaire de Nīmes5,000 enrolled

Overview

The effective management of acute postoperative pain remains a daily challenge despite the organizational efforts made and the techniques put in place. Thirty percent of patients who undergo surgery suffer from chronic post-surgical pain, of which 5 to 10% are of severe intensity. Many preoperative, intraoperative, and postoperative factors, related to the patient, the surgical procedure, or the anesthetic technique, have been incriminated as risk factors for chronic post-surgical pain. The severity of acute postoperative pain is recognized as one of the risk factors for the occurrence of chronic post-surgical pain on which we can hope to interact during the peri-operative period. In this cohort study, we wish to define the typologies of postoperative pain trajectories observed from Day 0 to Day 7 and to estimate the proportion of patients with an abnormal resolution of pain in a model of organization such as that of our institution, in classic hospitalization and in ambulatory care.

Study Type

OBSERVATIONAL

Enrollment

5,000

Conditions

Surgical Procedures, Operative Pain Chronic Pain

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * The patient must be insured or beneficiary of a health insurance plan * The patient is available for 3 months of follow-up * The patient has undergone a planned surgical procedure in one of the participating departments * The patient is willing and able to respond to the study questionnaires Exclusion Criteria: * The patient is participating in another study * The patient is in an exclusion period determined by a previous study * The patient is under judicial protection, under tutorship or curatorship * It is impossible to correctly inform the patient * Patient admitted to the ICU and still intubated at day 1

Outcomes

Primary Outcomes

The pain trajectory for the first 7 post-operative days.

The pain trajectory is the change in pain level evaluated by verbal numerical pain (from 0 to 10) from day 0 (surgery) to day 7.

Time frame: Day 7

Secondary Outcomes

The DN4 questionnaire

The Douleur Neuropathique 4 (DN4) questionnaire was developed by the French Neuropathic Pain Group and is a simple and objective tool, with the ability to distinguish nociceptive from neuropathic pain

Time frame: month 3

The EuroQuol EQ5D5L questionnaire

The descriptive system comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state.

Time frame: month 3

Since the surgery, do you have persistent pain? yes/no

Time frame: month 3

Verbal numerical scale for pain (ranging from 0 to 10)

Time frame: month 3

Have you had complications from your surgery? yes/no

Time frame: month 3

Pain Catastrophizing Scale (PCS)

The Pain Catastrophizing Scale (PCS) is a 13-item self-report measure designed to assess catastrophic thinking related to pain among adults with or without chronic pain.

Time frame: day -1 or day +1