Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .
Gabapentin Attenuates Late but Not Early Postoperative Pain After Thyroidectomy with Superficial Cervical Plexus Block
BACKGROUND : Preoperative oral gabapentin has been shown to reduce postoperative pain . However , the effects of gabapentin as an adjunct to regional anesthesia is unclear and its effects on chronic pain remains unknown . In patients undergoing thyroidectomy , we investigated the effects on early and late ( at 6 mo ) postoperative pain of preoperative oral gabapentin as an adjunct to superficial cervical plexus block ( SCPB ) . METHOD : Fifty consecutive consenting patients were r and omized to receive either 1200 mg of gabapentin ( Group G ) or placebo ( Group P ) 2 h preoperatively . Preoperative anxiety was assessed on a numeric scale from 0 to 6 . A SCPB was performed after a st and ardized induction of anesthesia . The primary outcome , analgesic drug consumption , was assessed during the procedure and postoperatively in the postanesthesia care unit and after discharge to the ward . Over the first 24 h , pain levels at rest and during swallowing were measured on a numeric scale from 0 to 10 . If the pain level was more than 4/10 at rest , patients received 1 g/6 h of IV paracetamol and /or 50 mg/6 h of IV tramadol as a rescue analgesic treatment in the interval . The day before operation and 6 mo after thyroidectomy , included patients were asked to answer a neuropathic pain diagnostic question naire . RESULTS : Population characteristics , preoperative anxiety , intraoperative drug consumption , procedure duration , and postoperative care unit stay were comparable in both groups . Analgesic consumption during the first 24 postoperative hours was similar in both groups ( G : 3 [ 0–5 ] doses/24 h ; P : 3 [ 1–5 ] doses/24 h ; P = NS ) , as well as pain at rest ( G : 2,2 [ 0.2–3.7 ] ; P : 2 [ 0–6.3 ] ; P = NS ) , and during swallowing ( G : 2.8 [ 0.4–8.9 ] ; P : 3 [ 1.4–6.3 ] ; P = NS ] ) . Eight patients had a diagnostic question naire score more than 3 , 6 mo after operation versus 2 in preoperative period ( P = 0.04 ) . Such delayed neuropathic pain complaints were reported in seven patients receiving SCPB alone and only in one patient receiving both SCPB and preoperative adjunctive oral gabapentin . ( P = 0.01 ) . CONCLUSION : Oral preoperative administration of gabapentin did not modify immediate pain management in thyroidectomy patients receiving SCPB , but prevented delayed neuropathic pain at 6 mo
Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .