Objectives: Inadequate postoperative pain control is common and is associated with poor clinical outcomes. This study aimed to identify preoperative predictors of poor postoperative pain control in adults undergoing inpatient surgery.
Design: Systematic review and meta-analysis DATA SOURCES: MEDLINE, Embase, CINAHL and PsycINFO were searched through October 2017.
Eligibility Criteria: Studies in any language were included if they evaluated postoperative pain using a validated instrument in adults (≥18 years) and reported a measure of association between poor postoperative pain control (defined by study authors) and at least one preoperative predictor during the hospital stay.
Data Extraction And Synthesis: Two reviewers screened articles, extracted data and assessed study quality. Measures of association for each preoperative predictor were pooled using random effects models.
Results: Thirty-three studies representing 53 362 patients were included in this review. Significant preoperative predictors of poor postoperative pain control included younger age (OR 1.18 [95% CI 1.05 to 1.32], number of studies, n=14), female sex (OR 1.29 [95% CI 1.17 to 1.43], n=20), smoking (OR 1.33 [95% CI 1.09 to 1.61], n=9), history of depressive symptoms (OR 1.71 [95% CI 1.32 to 2.22], n=8), history of anxiety symptoms (OR 1.22 [95% CI 1.09 to 1.36], n=10), sleep difficulties (OR 2.32 [95% CI 1.46 to 3.69], n=2), higher body mass index (OR 1.02 [95% CI 1.01 to 1.03], n=2), presence of preoperative pain (OR 1.21 [95% CI 1.10 to 1.32], n=13) and use of preoperative analgesia (OR 1.54 [95% CI 1.18 to 2.03], n=6). Pain catastrophising, American Society of Anesthesiologists status, chronic pain, marital status, socioeconomic status, education, surgical history, preoperative pressure pain tolerance and orthopaedic surgery (vs abdominal surgery) were not associated with increased odds of poor pain control. Study quality was generally high, although appropriate blinding of predictor during outcome ascertainment was often limited.
Conclusions: Nine predictors of poor postoperative pain control were identified. These should be recognised as potentially important factors when developing discipline-specific clinical care pathways to improve pain outcomes and to guide future surgical pain research.
Prospero Registration Number: CRD42017080682.
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http://dx.doi.org/10.1136/bmjopen-2018-025091 | DOI Listing |
Eur J Med Res
December 2024
Department of Neurosurgery, Neuromedicine Center, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038, People's Republic of China.
Background: Full-endoscopic microvascular decompression (fE-MVD) is an emerging treatment option for trigeminal neuralgia (TN). However, the risk factors associated with postoperative recurrence of TN after fE-MVD procedure remain controversial. The aim of the present study was to summarize the surgical technique of fE-MVD for the treatment of TN and to develop a predictive model for recurrence at 1 year postoperatively based on independent risk factors.
View Article and Find Full Text PDFJ Orthop Surg Res
December 2024
Department of Orthopaedic Surgery, Henry Ford Hospital, Henry Ford Health, 2799 W. Grand Blvd CFP-6, Detroit, MI, 48202, USA.
Background: Socioeconomic status has been recognized as a crucial social determinant of health influencing patient outcomes. Area Deprivation Index (ADI) is a validated measure of an area's socioeconomic status. Limited data exists on the impact of ADI and clinical outcomes and complications following rotator cuff repair (RCR).
View Article and Find Full Text PDFJ Orthop Surg Res
December 2024
Spinal Ward, The 900th Hospital of Joint Logistic Support Force, PLA, 156 Xierhuan Northern Road, FuZhou, 350025, China.
Background: There is currently no consensus on the surgical treatment of lumbar spondylolysis in young adults, and the nonunion rate remains relatively high even after surgery. Therefore, in this study, we proposed a modified intravertebral screw-rod fixation technique within a single vertebral segment and investigated the clinical efficacy of this modified fixation system combined with autologous cancellous bone grafting in the treatment of lumbar spondylolysis in young adults.
Methods: This study included 28 young adults with lumbar spondylolysis who were treated at our center between 2021 and 2023.
BMC Oral Health
December 2024
School of Dentistry, The University of Queensland, Brisbane, Australia.
Background: This randomized clinical trial aimed to evaluate the effect of intracanal cryotherapy with 2-4 °C normal saline irrigation on post-operative pain after single-visit non-surgical root canal retreatment.
Methods: Forty-six single-rooted, single-canal teeth requiring non-surgical root canal retreatment were randomly assigned to two groups (n = 23): a cryotherapy group and a control group. All the treatments were completed during a single visit.
J Cutan Med Surg
December 2024
The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.
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