February 19, 2015
New scoring system helps predict risk of chronic pain after surgery
Chicago – February 19, 2015 – There are many variables that contribute to a patient’s risk of chronic pain after surgery; physicians are still exploring ways to identify those variables prior to surgery. A study published in the Online First edition of Anesthesiology, the official medical journal of the American Society of Anesthesiologists® (ASA®), gives physicians a new planning tool to help identify patients’ risks of chronic pain after surgery.
“Our study rigorously examined patients’ risks of chronic postsurgical pain,” said Antonio Montes Perez, M.D., Ph.D., lead study author, department of anesthesiology, Hospital de Mar in Barcelona, Spain. “We sought a tool that would reliably predict a patient’s risk preoperatively, at the time surgery is being planned. We developed a risk scoring system that can be used before surgery, when care planning and preventive measures are critically important.”
The researchers followed 2,929 patients undergoing three common types of surgery (hernia repair, hysterectomy and thoracotomy) for two years, assessing their pain at four, 12 and 24 months after surgery. The study, referred to as GENDOLCAT, demonstrated that there is substantial risk of chronic pain after surgery, with 18 percent of the patients developing chronic pain after four months, and 5.2 percent still experiencing chronic pain after 24 months.
The scoring system was developed based on six predictors among the patients in the study:
• Type of surgery
• Physical health status
• Mental health status
• Preoperative pain in the surgical area
• Preoperative pain in another area.
According to Dr. Montes, risk scoring facilitates informed patient-physician discussion of strategies so together they can:
• Carefully consider the surgery
• Plan to use the most appropriate pain relief techniques during the recovery period
• Implement preventive measures before and during surgery
• Set a pain monitoring schedule and follow-ups
The researchers also tested for 90 genetic predictors, but found they did not play a role in the development of chronic pain after surgery in this study.
“This scoring system improves the way we examine patients prior to surgery, which is based on an extensive physical examination rather than just clinical factors,” said Dr. Montes. “As far as genetic influence, additional research should be conducted to determine whether or not other genetic factors not considered in this study contribute to chronic pain after surgery.
The American Society of Anesthesiologists
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 52,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring physician anesthesiologists evaluate and supervise the medical care of patients before, during and after surgery to provide the highest quality and safest care every patient deserves.
For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount. Join the social conversation today. Like ASA on Facebook, follow ASALifeline on Twitter.
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