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Abstract
Few studies have investigated factors associated with acute postsurgical pain (APSP) trajectories, and whether the APSP trajectory can predict chronic postsurgical pain (CPSP) remains unclear. We aimed to identify the predictors of APSP trajectories in patients undergoing gastrointestinal surgery. Moreover, we hypothesised that APSP trajectories were independently associated with CPSP. We conducted a prospective cohort study of 282 patients undergoing gastrointestinal surgery to describe APSP trajectories. Psychological questionnaires were administered 1 day before surgery. Meanwhile, demographic characteristics and perioperative data were collected. Average pain intensity during the first 7 days after surgery was assessed by a numeric rating scale (NRS). Persistent pain intensity was evaluated at 3 and 6 months postoperatively by phone call interview. CPSP was defined as pain at the incision site or surrounding areas of surgery with a pain NRS score ≥ 1 at rest. The intercept and slope were calculated by linear regression using the least squares method. The predictors for the APSP trajectory and CPSP were determined using multiple linear regression and multivariate logistic regression, respectively. Body mass index, morphine milligram equivalent (MME) consumption, preoperative chronic pain and anxiety were predictors of the APSP trajectory intercept. Moreover, MME consumption and preoperative anxiety could independently predict the APSP trajectory slope. The incidence of CPSP at 3 and 6 months was 30.58% and 16.42% respectively. APSP trajectory and age were predictors of CPSP 3 months postoperatively, while female sex and preoperative anxiety were predictive factors of CPSP 6 months postoperatively. Preoperative anxiety and postoperative analgesic consumption can predict APSP trajectory. In addition, pain trajectory was associated with CPSP. Clinicians need to stay alert for these predictors and pay close attention to pain resolution.
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1 Xishan People’s Hospital of Wuxi City, Department of Anesthesiology, Wuxi, China
2 Southeast University, Department of Anesthesiology, Zhongda Hospital, Medical School, Nanjing, China (GRID:grid.263826.b) (ISNI:0000 0004 1761 0489)
3 Nanjing Medical University, Department of Anesthesiology, The Second Affiliated Hospital, Nanjing, China (GRID:grid.89957.3a) (ISNI:0000 0000 9255 8984)
4 The First Affiliated Hospital of Zhengzhou University, Department of Anesthesiology, Pain and Perioperative Medicine, Zhengzhou, China (GRID:grid.412633.1) (ISNI:0000 0004 1799 0733)
5 Xishan People’s Hospital of Wuxi City, Department of Anesthesiology, Wuxi, China (GRID:grid.412633.1)