Incidence, Risk Factors and Impact of Significant Pain in Patients Undergoing Neurosurgery

Study Overview
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Brief Summary
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The proposed study intends to evaluate incidence of postoperative pain after neurosurgery. This study is likely to help in understanding of the magnitude of this problem in our country and inform about possible predictors which will help institute pre-emptive interventions to mitigate modifiable risk factors of pain after neurosurgery.

Detailed Description
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Data regarding potential risk factors for postoperative pain will be collected. Preoperative factors (preoperative pain, anxiety or depression, perception about surgery, age, gender, socio-economic status, educational level, domicile location, obesity, surgical site [infratentorial or supratentorial or cervical, thoracic or lumbar], use of steroids and analgesics), and intraoperative factors (scalp/ESP/caudal block, incision site infiltration, dose of analgesics such as opioids, paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs), co-analgesics such as nitrous oxide, gabapentionoids, dexmedetomidine, magnesium or lignocaine infusion, anti-epileptics, steroids, minimum alveolar concentration (MAC) of inhalational anesthetics, and duration of surgery and anesthesia) that are likely to be associated with occurrence of postoperative pain will be explored along with relationship between acute and persistent postoperative pain and between intraoperative nociception and postoperative pain.

Official Title
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Incidence, Risk Factors and Impact of Significant Pain in Patients Undergoing Neurosurgery

Conditions
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Postoperative Pain, Neurosurgery

Intervention / Treatment
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* Procedure: Neurosurgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: all eligible consecutive consenting adult patients aged > 18 years with preoperative Glasgow Coma Scale (GCS) score of 15 undergoing elective craniotomies and spine surgeries Exclusion Criteria: children, patients with GCS < 15, patients not extubated within 2 hours of end of anesthesia and those who not able to respond to our questions on outcomes

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Cranial neurosurgery<br>Patients undergoing cranial neurosurgery | Procedure: Neurosurgery<br>* Neurosurgery<br>|
| Non-cranial neurosurgery<br>Patients undergoing non-cranial neurosurgery including spine surgery | Procedure: Neurosurgery<br>* Neurosurgery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative pain using Numerical Rating Scale | Acute postoperative pain | on days 1-3 after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| duration of postoperative hospital stay in days | duration of postoperative hospital stay in days | through hospital stay, an average of 10 days | 
| postoperative sleep quality using Likert 1-5 scale | sleep quality assessment | Day 2 after surgery | 
| patient satisfaction using Likert scale 1-5 | patient satisfaction assessment using Likert scale 1-5 | Day 2 after surgery | 
| Persistent postoperative pain using Numerical Rating Scale (NRS) | Chronic Postoperative Pain measured using NRS (from 0 to 10, with 0 = no pain and 10 = maximal pain | 3 and 6 months after surgery |