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 .
Perioperative gabapentin for the prevention of persistent pain after thoracotomy: a randomized controlled trial.
OBJECTIVES To evaluate the effect of perioperative gabapentin treatment for the prevention of persistent  post-thoracotomy pain  and to establish whether gabapentin has a significant therapeutic impact on acute postoperative pain . METHODS Consecutive patients with pulmonary malignancies scheduled for anterior thoracotomy were enrolled in this r and omized , double-blinded , placebo-controlled trial . Patients were given 1200 mg gabapentin or placebo 2 h before surgery followed by increasing doses during 5 postoperative days : 600 mg for day 1 ; 900 mg for day 2 ; and 1200 mg for days 3 - 5 . Effective pain relief was provided with perioperative multimodal analgesia with epidural infusion of bupivacaine and morphine for 72 h , and oral acetaminophen , ibuprofen and morphine . The main outcome was persistent post-thoracotomy pain at 6 months . Secondary outcomes included measures of early postoperative post-thoracotomy pain , morphine requirements , recovery and analgesia-related adverse effects over the first 3 weeks as well as persistent post-thoracotomy pain at 3 months . RESULTS A total of 104 patients were r and omly assigned to the intervention or control group ; 86 ( 83 % ) patients were available for the 14-day analysis , 76 ( 73 % ) for the 3-month analysis and 67 ( 64 % ) for the 6-month follow-up . At 6 months postoperatively , 47 % of patients treated with gabapentin reported persistent post-thoracotomy pain compared with 49 % in the placebo group ( P = 0.9 ) . No overall clinical ly or statistically significant differences were observed between groups receiving placebo and gabapentin , respectively , for the secondary outcome measures and treatment-related adverse events . CONCLUSIONS We found no evidence for the superiority of gabapentin over placebo for the treatment of acute pain following thoracotomy or for the prevention of persistent post-thoracotomy pain
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 .