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2. Movement-Evoked Pain Versus Pain at Rest in Postsurgical Clinical Trials and Meta-Analyses: Protocol for a Follow-Up Systematic Review

Author

Camiré, Daenis, Erb, Jason, Kehlet, Henrik, Brennan, Timothy, and Gilron, Ian

Subjects
Medicine, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

BackgroundPostoperative pain is one of the most prevalent and disabling complications of surgery that is associated with personal suffering, delayed functional recovery, prolonged hospital stay, perioperative complications, and chronic postsurgical pain. Accumulating evidence has pointed to the important distinction between pain at rest (PAR) and movement-evoked pain (MEP) after surgery. In most studies including both measures, MEP has been shown to be substantially more severe than PAR. Furthermore, as MEP is commonly experienced during normal activities (eg, breathing, coughing, and walking), it has a greater adverse functional impact than PAR. In a previous systematic review conducted in 2011, only 39% of reviewed trials included MEP as a trial outcome and 52% failed to identify the pain outcome as either PAR or MEP. Given the recent observations of postsurgical pain trials that continue to neglect the distinction between PAR and MEP, this updated review seeks to evaluate the degree of progress in this area. ObjectiveThis updated review will include postsurgical clinical trials and meta-analyses in which the primary outcome was early postoperative pain intensity. The primary outcome for this review is the reporting of MEP (vs PAR) as an outcome measure for each trial and meta-analysis. Secondary outcomes include whether trials and meta-analyses distinguished between PAR and MEP. MethodsTo be consistent with the 2011 review that we are updating, this review will again focus on randomized controlled trials and meta-analyses, from Medical Literature Analysis and Retrieval System Online and EMBASE databases, focusing on pain treatment after thoracotomy, knee arthroplasty, and hysterectomy in humans. Trials and meta-analyses will be characterized as to whether or not they assessed PAR and MEP; whether their pain outcome acknowledged the distinction between PAR and MEP; and, for trials assessing MEP, which pain-evoking maneuver(s) were used. ResultsScoping review and pilot data extraction are under way, and the results are expected by March 2020. ConclusionsIt is our belief that every postsurgical analgesic trial should include MEP as an outcome measure. The previous 2011 review was expected to have an impact on more widespread assessment of MEP in subsequent postoperative pain treatment trials. Thus, the purpose of this follow-up review is to reevaluate the frequency of use of MEP as a trial outcome, compared with PAR, in more recently published postoperative pain trials. Trial RegistrationPROSPERO CRD42019125855; https://tinyurl.com/qw9dty8 International Registered Report Identifier (IRRID)DERR1-10.2196/15309

Published
2020
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7. Neuropathic pain after surgery – A clinical validation study and assessment of accuracy measures of the 5-item NeuPPS scale

Author

Andersen Kenneth Geving, Christensen Karl Bang, Kehlet Henrik, and Mejdahl Mathias Kvist

Subjects
scale validation, rasch analysis, item response model, persistent postoperative pain, intercostobrachial nerve, neuropathy, neuropathic pain, quantitative sensory testing, breast cancer, Special situations and conditions, RC952-1245, Medicine (General), R5-920
Abstract

The aim of this study was to validate the Neuropathic Pain for Post-Surgical Patients (NeuPPS) scale against clinically verified neuropathic pain (NP) by quantitative sensory testing (QST) as well as evaluation of other psychometric properties. The NeuPPS is a validated 5-item scale designed to evaluate NP in surgical populations.

Published
2024
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8. Genome-wide association studies with experimental validation identify a protective role for B lymphocytes against chronic post-surgical pain

Author

Parisien, Marc, van Reij, Roel R.I., Khoury, Samar, Koseli, Eda, Karaky, Mohamad, Silva, Jaqueline R., Taheri, Golnar, van den Hoogen, Nynke J., Peng, Garrie, Allegri, Massimo, De Gregori, Manuela, Chelly, Jacques E., Rakel, Barbara A., Aasvang, Eske K., Kehlet, Henrik, Buhre, Wolfgang F.F.A., Bryant, Camron D., Damaj, M. Imad, King, Irah L., Ghasemlou, Nader, Mogil, Jeffrey S., Joosten, Elbert A.J., and Diatchenko, Luda

Published
2024
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12. Machine-learning vs. logistic regression for preoperative prediction of medical morbidity after fast-track hip and knee arthroplasty—a comparative study

Author

Michelsen, Christian, Jørgensen, Christoffer C., Heltberg, Mathias, Jensen, Mogens H., Lucchetti, Alessandra, Petersen, Pelle B., Petersen, Troels, Kehlet, Henrik, Madsen, Frank, Hansen, Torben B., Gromov, Kirill, Jakobsen, Thomas, Varnum, Claus, Overgaard, Soren, Rathsach, Mikkel, and Hansen, Lars

Published
2023
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14. Robot-assisted laparoscopic radical cystectomy with intracorporeal ileal conduit diversion versus open radical cystectomy with ileal conduit for bladder cancer in an ERAS setup (BORARC): protocol for a single-centre, double-blinded, randomised feasibility study

Author

Maibom, Sophia Liff, Joensen, Ulla Nordström, Aasvang, Eske Kvanner, Rohrsted, Malene, Thind, Peter Ole, Bagi, Per, Kistorp, Thomas, Poulsen, Alicia Martin, Salling, Lisbeth Nerstrøm, Kehlet, Henrik, Brasso, Klaus, and Røder, Martin Andreas

Published
2023
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20. Systematic reviews and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative: mortality, morbidity, and organ failure

Author

Myles, Paul, Gan, T.J., Kurz, Andrea, Peyton, Phil, Sessler, Dan, Tramèr, Martin, Cyna, Alan, De Oliveira, Gildasio S., Jr., Wu, Christopher, Jensen, Mark, Kehlet, Henrik, Botti, Mari, Boney, Oliver, Haller, Guy, Grocott, Mike, Cook, Tim, Fleisher, Lee, Neuman, Mark, Story, David, Gruen, Russell, Bampoe, Sam, Evered, Lis, Scott, David, Silbert, Brendan, van Dijk, Diederik, Kalkman, Cor, Chan, Matthew, Grocott, Hilary, Eckenhoff, Rod, Rasmussen, Lars, Eriksson, Lars, Beattie, Scott, Wijeysundera, Duminda, Landoni, Giovanni, Leslie, Kate, Biccard, Bruce, Howell, Simon, Nagele, Peter, Richards, Toby, Lamy, Andre, Lalu, Manoj, Pearse, Rupert, Mythen, Monty, Canet, Jaume, Moller, Ann, Gin, Tony, Schultz, Marcus, Pelosi, Paolo, Gabreu, Marcelo, Futier, Emmanuel, Creagh-Brown, Ben, Abbot, Tom, Klein, Andy, Corcoran, Tomas, Cooper, D. Jamie, Dieleman, Stefan, Diouf, Elisabeth, McIlroy, David, Bellomo, Rinaldo, Shaw, Andrew, Prowle, John, Karkouti, Keyvan, Billings, Josh, Mazer, David, Jayarajah, Mohindas, Murphy, Michael, Bartoszko, Justyna, Sneyd, Rob, Morris, Steve, George, Ron, Moonesinghe, Ramani, Shulman, Mark, Lane-Fall, Meghan, Nilsson, Ulrica, Stevenson, Nathalie, van Klei, Wilton, Cabrini, Luca, Miller, Tim, Jackson, Sandy, Buggy, Donal, Short, Tim, Riedel, Bernhard, Gottumukkala, Vijay, Pace, Nathan, Alkhaffaf, Bilal, Johnson, Mark, Jackson, Alexander I.R., Pearse, Rupert M., Cooper, D. James, van Klei, Wilton A., Miller, Timothy E., Moonesinghe, S. Ramani, Myles, Paul S., and Grocott, Michael P.W.

Published
2023
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34. Psychopharmacological treatment in patients planned for hip or knee replacement.

Author

Kornvig, Simon, Kehlet, Henrik, Jørgensen, Christoffer Calov, Fink‐Jensen, Anders, Videbech, Poul, Lindberg‐Larsen, Martin, Gromov, Kirill, Rasmussen, Mathias Bæk, Bieder, Manuel Josef, and Varnum, Claus

Subjects
*TOTAL knee replacement, *TOTAL hip replacement, *SEROTONIN uptake inhibitors, *KNEE, *GENERAL practitioners, *ANKLE, *PSYCHIATRIC treatment
Abstract

Psychopharmacological treatment may be an independent risk factor for increased length of stay and readmission after hip and knee replacement. Thus, temporary perioperative discontinuation may be beneficial. However, little is known regarding the treatments, and not all are feasible to discontinue. Therefore, the aim of this study was to describe the treatments in terms of type, dose, duration, indication and initiating physician to assess the feasibility of temporary perioperative discontinuation. We included 482 patients planned for hip or knee replacement in psychopharmacological treatment for psychiatric disorders from 2021 to 2023 at five orthopaedic departments in Denmark. Most patients were treated with antidepressants (89%); most frequently, either selective serotonin reuptake inhibitors (SSRIs; 48%) or serotonin‐norepinephrine reuptake inhibitors (SNRIs; 21%). The majority received monotherapy (70%); most frequently, an SSRI (36%) or an SNRI (12%). Most antidepressants were initiated by general practitioners (71%), and the treatments had lasted for more than a year (87%). The doses of SSRIs/SNRIs were moderate, and the most frequent indication for antidepressants was depression (77%). These results imply that temporary perioperative SSRI/SNRI discontinuation may be feasible in hip and knee replacement patients and support a future randomized controlled trial investigating the potential benefits of temporary discontinuation. [ABSTRACT FROM AUTHOR]

Published
2024
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37. Systematic review and consensus definitions for the Standardized Endpoints in Perioperative Medicine (StEP) initiative: cardiovascular outcomes

Author

Myles, Paul, Gan, T.J., Kurz, Andrea, Peyton, Phil, Sessler, Dan, Tramèr, Martin, Cyna, Alan, De Oliveira, Gildasio S., Jr., Wu, Christopher, Jensen, Mark, Kehlet, Henrik, Botti, Mari, Boney, Oliver, Haller, Guy, Grocott, Mike, Cook, Tim, Fleisher, Lee, Neuman, Mark, Story, David, Gruen, Russell, Bampoe, Sam, Evered, Lis, Scott, David, Silbert, Brendan, van Dijk, Diederik, Kalkman, Cor, Chan, Matthew, Grocott, Hilary, Eckenhoff, Rod, Rasmussen, Lars, Eriksson, Lars, Beattie, Scott, Wijeysundera, Duminda, Landoni, Giovanni, Leslie, Kate, Biccard, Bruce, Howell, Simon, Nagele, Peter, Richards, Toby, Lamy, Andre, Lalu, Manoj, Bartlett, Richard J., McMonnies, Robert, Gerstl, Jakob V.E., Jay, Mohammad, Kishlyansky, David, Machina, Matthew, Bobcock, Matthew, Feng, Simon, Pearse, Rupert, Mythen, Monty, Canet, Jaume, Moller, Ann, Gin, Tony, Schultz, Marcus, Pelosi, Paolo, Gabreu, Marcelo, Futier, Emmanuel, Creagh-Brown, Ben, Abbott, Tom, Klein, Andy, Corcoran, Tomas, Cooper, D. Jamie, Dieleman, Stefan, Diouf, Elisabeth, McIlroy, David, Bellomo, Rinaldo, Shaw, Andrew, Prowle, John, Karkouti, Keyvan, Billings, Josh, Mazer, David, Jayarajah, Mohindas, Murphy, Michael, Bartoszko, Justyna, Sneyd, Rob, Morris, Steve, George, Ron, Moonesinghe, Ramani, Shulman, Mark, Lane-Fall, Meghan, Nilsson, Ulrica, Stevenson, Nathalie, Cooper, Jamie (DJ), van Klei, Wilton, Cabrini, Luca, Miller, Tim, Pace, Nathan, Jackson, Sandy, Buggy, Donal, Short, Tim, Riedel, Bernhard, Gottumukkala, Vijay, Alkhaffaf, Bilal, Johnson, Mark, Beattie, W. Scott, Bocock, Matthew, Wijeysundera, Duminda N., and Fleisher, Lee A.

Published
2021
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40. Perioperative association between c‐reactive protein, pain catastrophizing and acute pain after total knee arthroplasty: A secondary analysis of two randomised trials.

Author

Springborg, Anders H., Kehlet, Henrik, Nielsen, Niklas I., Gromov, Kirill, Troelsen, Anders, Varnum, Claus, and Foss, Nicolai B.

Subjects
*KNEE pain, *TOTAL knee replacement, *PAIN catastrophizing, *C-reactive protein, *SECONDARY analysis, *POSTOPERATIVE pain
Abstract

Background Methods Results Conclusion Total knee arthroplasty is associated with an inflammatory response and high levels of pain in a subset of patients. Pain catastrophizing has been associated with acute postoperative pain. The association between these variables has not been investigated in an optimised fast‐track setup including preoperative glucocorticoids. The aim of this study was, first, to investigate the correlation between the increase in postoperative c‐reactive protein (CRP) and acute postoperative pain after total knee arthroplasty, and second, to investigate the correlation between the increase in CRP and preoperative pain catastrophizing.This study is a secondary analysis of data from 119 patients participating in two randomised controlled trials. Correlation analyses were performed for preoperative CRP and CRP increase at 24 and 48 h and pain during a well‐defined mobilisation at 24 and 48 h after total knee arthroplasty. Additionally, correlation analyses were performed between CRP increase and pain catastrophizing using the pain catastrophizing scale.There was no correlation between preoperative CRP or postoperative CRP increase and pain at both 24 and 48 h. Analyses were similar when separated into high and low pain catastrophizers. There was no correlation between preoperative CRP or postoperative CRP increase and pain catastrophizing.There was no association between the postoperative CRP response and postoperative acute pain or pain catastrophizing in patients undergoing total knee arthroplasty in a well‐defined multimodal fast‐track regime including preoperative glucocorticoids. These results suggest that acute pain after knee arthroplasty is not reflected by CRP when applying preoperative glucocorticoids. [ABSTRACT FROM AUTHOR]

Published
2024
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49. Systematic review and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative: infection and sepsis

Author

Myles, Paul, Gan, Tang Joon, Kurz, Andrea, Peyton, Phil, Sessler, Dan, Tramèr, Martin, Cyna, Alan, De Oliveira, Gildasio S., Jr., Wu, Christopher, Jensen, Mark, Kehlet, Henrik, Botti, Mari, Boney, Oliver, Haller, Guy, Grocott, Mike, Cook, Tim, Fleisher, Lee, Neuman, Mark, Story, David, Gruen, Russell, Bampoe, Sam, Evered, Lis, Scott, David, Silbert, Brendan, van Dijk, Diederik, Kalkman, Cor, Chan, Matthew, Grocott, Hilary, Eckenhoff, Rod, Rasmussen, Lars, Eriksson, Lars, Beattie, Scott, Wijeysundera, Duminda, Landoni, Giovanni, Leslie, Kate, Biccard, Bruce, Howell, Simon, Nagele, Peter, Richards, Toby, Lamy, Andre, Lalu, Manoj, Pearse, Rupert, Mythen, Monty, Canet, Jaume, Moller, Ann, Gin, Tony, Schultz, Marcus, Pelosi, Paolo, Gabreu, Marcelo, Futier, Emmanuel, Creagh-Brown, Ben, Fowler, Alexander, Abbott, Tom, Klein, Andy, Corcoran, Tomas, Cooper, David James, Dieleman, Stefan, Diouf, Elisabeth, McIlroy, David, Bellomo, Rinaldo, Shaw, Andrew, Prowle, John, Karkouti, Keyvan, Billings, Josh, Mazer, David, Jayarajah, Mohindas, Murphy, Michael, Bartoszko, Justyna, Sneyd, Rob, Morris, Steve, George, Ron, Moonesinghe, Ramani, Shulman, Mark, Lane-Fall, Meghan, Nilsson, Ulrica, Stevenson, Nathalie, Cooper, Jamie (DJ), van Klei, Wilton, Cabrini, Luca, Miller, Tim, Pace, Nathan, Jackson, Sandy, Buggy, Donal, Short, Tim, Riedel, Bernhard, Gottumukkala, Vijay, Alkhaffaf, Bilal, Johnson, Mark, Barnes, Jonathan, Hunter, Jennifer, Harris, Steve, Shankar-Hari, Manu, Jammer, Ib, Klein, Andrew A., Grocott, Michael P.W., and Mythen, Michael G.

Published
2019
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