Evaluation of Pain Trajectories After Surgery and Their Potential Relationship With Chronicity at 3 Months

Study Overview
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Brief Summary
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The effective management of acute postoperative pain remains a daily challenge despite the organizational efforts made and the techniques put in place. Thirty percent of patients who undergo surgery suffer from chronic post-surgical pain, of which 5 to 10% are of severe intensity. Many preoperative, intraoperative, and postoperative factors, related to the patient, the surgical procedure, or the anesthetic technique, have been incriminated as risk factors for chronic post-surgical pain. The severity of acute postoperative pain is recognized as one of the risk factors for the occurrence of chronic post-surgical pain on which we can hope to interact during the peri-operative period. In this cohort study, we wish to define the typologies of postoperative pain trajectories observed from Day 0 to Day 7 and to estimate the proportion of patients with an abnormal resolution of pain in a model of organization such as that of our institution, in classic hospitalization and in ambulatory care.

Official Title
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Evaluation of Pain Trajectories After Surgery and Their Potential Relationship With Chronicity at 3 Months: a Single-center Prospective Cohort Study

Conditions
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Surgical Procedures, Operative, Pain, Chronic Pain

Intervention / Treatment
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* Other: In hospital pain evaluation
* Other: In hospital questionnaires
* Other: Telephone contact at 3 months


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The patient must be insured or beneficiary of a health insurance plan The patient is available for 3 months of follow-up The patient has undergone a planned surgical procedure in one of the participating departments The patient is willing and able to respond to the study questionnaires Exclusion Criteria: The patient is participating in another study The patient is in an exclusion period determined by a previous study The patient is under judicial protection, under tutorship or curatorship It is impossible to correctly inform the patient Patient admitted to the ICU and still intubated at day 1

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 |
| --- | --- |
| The study population<br>The study population consists of adult surgery patients at the Nîmes University Hospital, with recruitment based on the operating theater program and for a predefined list of surgeries. | Other: In hospital pain evaluation<br>* Patients will evaluate their pain levels via a verbal numerical scale on days 1(or-1), 2, 3, 4, 5, 6 & 7.<br>Other: In hospital questionnaires<br>* Patients are required to fill out the PCS questionnaire between on day -1 or +1.<br>Other: Telephone contact at 3 months<br>* Patients will be contacted at 3 months post-surgery for pain questionnaires DN4 and EQ5D5L.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The pain trajectory for the first 7 post-operative days. | The pain trajectory is the change in pain level evaluated by verbal numerical pain (from 0 to 10) from day 0 (surgery) to day 7. | Day 7 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The DN4 questionnaire | The Douleur Neuropathique 4 (DN4) questionnaire was developed by the French Neuropathic Pain Group and is a simple and objective tool, with the ability to distinguish nociceptive from neuropathic pain | month 3 | 
| The EuroQuol EQ5D5L questionnaire | The descriptive system comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state. | month 3 | 
| Since the surgery, do you have persistent pain? yes/no | Since the surgery, do you have persistent pain? yes/no | month 3 | 
| Verbal numerical scale for pain (ranging from 0 to 10) | Verbal numerical scale for pain (ranging from 0 to 10) | month 3 | 
| Have you had complications from your surgery? yes/no | Have you had complications from your surgery? yes/no | month 3 | 
| Pain Catastrophizing Scale (PCS) | The Pain Catastrophizing Scale (PCS) is a 13-item self-report measure designed to assess catastrophic thinking related to pain among adults with or without chronic pain. | day -1 or day +1 | 
| Cumulative consumption of antalgic drugs | Cumulative consumption of antalgic drugs | day -1 or day +1 | 
| Cumulative consumption of antalgic drugs | Cumulative consumption of antalgic drugs | day 2 | 
| Cumulative consumption of antalgic drugs | Cumulative consumption of antalgic drugs | day 3 | 
| Cumulative consumption of antalgic drugs | Cumulative consumption of antalgic drugs | day 4 | 
| Cumulative consumption of antalgic drugs | Cumulative consumption of antalgic drugs | day 5 | 
| Cumulative consumption of antalgic drugs | Cumulative consumption of antalgic drugs | day 6 | 
| Cumulative consumption of antalgic drugs | Cumulative consumption of antalgic drugs | day 7 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pain trajectory