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 .
Effects of epidural anesthesia on acute and chronic pain after coronary artery bypass grafting.
OBJECTIVE To evaluate the effects of thoracic epidural anesthesia ( TEA ) as an adjunct to general anesthesia ( GA ) on postoperative pain after coronary artery bypass grafting ( CABG ) . METHODS Between April 2009 and March 2010 , 40 patients with ischemic heart disease scheduled for elective CABG were prospect ively r and omized to receive either GA ( n = 20 ) or GA + TEA ( n = 20 ) . Through epidural catheters , patients received an infusion of ( 10 - 20 mg/h ) 0.25%-bupivacaine intraoperatively and during the first 24 hours after surgery . Study endpoints included assessment of postoperative pain at rest and with coughing , rescue analgesic need , and postoperative course . RESULTS The differences in pain scores were decreased at rest during 6 ( 0.1 ± 0.3 vs. 2.4 ± 1.8 ; p < 0.05 ) and 12 hours ( 0.1 ± 0.3 vs. 3.9 ± 2.3 ; p < 0.05 ) and with coughing at 6 ( 0.1 ± 0.3 vs. 5.6 ± 2.2 ; p < 0.05 ) , 12 ( 0.1 ± 0.3 vs. 5.9 ± 2.3 ; p < 0.05 ) , and 24 hours ( 0.05 ± 0.2 vs. 4.6 ± 2.9 ; p < 0.05 ) in the GA + TEA group . At one-month follow-up , pain scores were decreased in GA + TEA group ( 0.3 ± 0.7 vs. 1.6 ± 1.3 ; p = 003 ) . There was no significant difference at three and six months . Mechanical ventilation time ( 4.7 ± 1.2 vs. 2.9 ± 1.1 hours ; p < 0.05 ) , intensive care unit stay ( 28.4 ± 9.0 vs. 22.4 ± 3.4 hours ; p < 0.05 ) , and hospital stay ( 7.2 ± 1.1 vs. 6.1 ± 0.3 days ; p = 0.001 ) were reduced in the GA + TEA group . CONCLUSIONS TEA significantly reduced the intensity of postoperative pain and analgesic consumption in the early postoperative period following CABG . The delivery of effective analgesia along with conventional medications may prevent chronic pain after 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 .