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 .
Stress doses of hydrocortisone reduce chronic stress symptoms and improve health-related quality of life in high-risk patients after cardiac surgery: a randomized study.
OBJECTIVES Improvement in health-related quality of life is a major object of cardiac surgery . However , high stress exposure during the perioperative period of cardiac surgery can result in the formation of traumatic memories and symptoms of chronic stress or even posttraumatic stress disorder , which can have negative effects on health-related quality -of-life outcome . In this controlled study we examined whether exogenously administered stress doses of hydrocortisone during cardiac surgery reduce perioperative stress exposure and the long-term incidence of chronic stress symptoms and improve health-related quality of life after cardiac surgery . METHODS Thirty-six high-risk patients undergoing cardiac surgery were prospect ively r and omized to receive either stress doses of hydrocortisone or placebo . Of 28 available patients at 6 months after cardiac surgery , 14 had received hydrocortisone , and 14 had received placebo .  Traumatic memories , chronic stress symptoms ( posttraumatic stress disorder scores ) , and health-related quality of life were measured by using vali date d question naires . RESULTS Compared with patients from the placebo group , patients from the hydrocortisone group had a significantly shorter duration of intensive care unit treatment , required lower doses of the stress hormone norepinephrine during cardiac surgery , and had significantly fewer stress symptoms and a better health-related quality of life regarding physical function , chronic pain , general health , vitality , and mental health during follow-up . The groups did not differ with regard to the number or type of intensive care unit-related traumatic memories . CONCLUSIONS The use of stress doses of hydrocortisone in high-risk cardiac surgical patients reduces perioperative stress exposure , decreases chronic stress symptoms , and improves health-related quality of life at 6 months after cardiac surgery
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 .