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Acute postoperative pain impact trajectories and factors contributing to trajectory membership.
Giordano, Nicholas A; Kent, Michael L; Kroma, Raymond B; Rojas, Winifred; Lindl, Mary Jo; Lujan, Eugenio; Buckenmaier, Chester C; Highland, Krista B.
Afiliación
  • Giordano NA; Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia.
  • Kent ML; Department of Anesthesiology, Duke University, Durham, North Carolina.
  • Kroma RB; Defense and Veterans Center for Integrative Pain Management, Department of Anesthesiology, Uniformed Services University, Bethesda, Maryland.
  • Rojas W; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland.
  • Lindl MJ; Defense and Veterans Center for Integrative Pain Management, Department of Anesthesiology, Uniformed Services University, Bethesda, Maryland.
  • Lujan E; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland.
  • Buckenmaier CC; Defense and Veterans Center for Integrative Pain Management, Department of Anesthesiology, Uniformed Services University, Bethesda, Maryland.
  • Highland KB; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland.
Pain Med ; 24(7): 829-836, 2023 07 05.
Article en En | MEDLINE | ID: mdl-36579887
BACKGROUND: Ongoing postoperative pain assessments are vital to optimizing pain management and attenuating the development of poor health outcomes after surgery. This study aimed to characterize acute multidimensional trajectories of pain impact on physical function, sleep, mood, and stress and to examine clinical characteristics and demographics associated with trajectory membership. Additionally, this study compared levels of pain intensity and prescription opioid use at 2 weeks and 1 month postoperatively across acute symptom trajectories. METHODS: Participants (N = 285) undergoing total knee arthroplasty, total hip arthroplasty, and spinal fusion procedures were recruited for this multisite prospective observational study. Longitudinal, joint k-means clustering was used to identify trajectories based on pain impact on activity, sleep, mood, and stress. RESULTS: Three distinct pain impact trajectories were observed: Low (33.7%), Improving (35.4%), and Persistently High (30.9%). Participants in the Persistently High impact trajectory reported pain interfering moderately to severely with activity, sleep, mood, and stress. Relative to other trajectories, the Persistently High impact trajectory was associated with greater postoperative pain at 1 month postoperatively. Preoperatively, participants in the Persistently High impact trajectory reported worse Pain Catastrophizing Scale scores and PROMIS Pain Interference, PROMIS Anxiety, and PROMIS Social Isolation scores than did participants presenting with other trajectories. No statistical differences in opioid use were observed across trajectories. CONCLUSIONS: Variation in acute postoperative pain impact on activity, sleep, mood, and stress exists. Given the complex nature of patients' postoperative pain experiences, understanding how psychosocial presentations acutely change throughout hospitalization could assist in guiding clinicians' treatment choices and risk assessments.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ansiedad / Analgésicos Opioides Tipo de estudio: Observational_studies / Prognostic_studies Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Pain Med Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Georgia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ansiedad / Analgésicos Opioides Tipo de estudio: Observational_studies / Prognostic_studies Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Pain Med Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Georgia Pais de publicación: Reino Unido