Understanding the Acute Pain Phenotype in Patients Undergoing Surgery

Mass General Brigham

Status: Enrolling

Conditions: Chronic Post Operative Pain; Opioid Use; Acute Pain

Treatments: Other: no acute pain consultation; Other: acute pain consultation; Procedure: no regional anesthesia; Procedure: regional anesthesia

Study type: Observational

Funder types: Other; NIH

Identifiers

NCT06466941

2R35GM128691-06 (U.S. NIH Grant/Contract)

2023P003642

Details and patient eligibility

About

The goal of this observational study is to learn about how regional anesthesia (numbing medication) affects pain in patients with different psychosocial phenotypes such as different levels of concern about pain, sleep issues, and anxiety, who are having surgery.

The main questions are:

1. Do psychosocial factors such as concerns about pain, sleep, anxiety affect the effectiveness of regional anesthesia?
2. Do psychosocial factors and regional anesthesia affect the amount of opioids used after surgery?
3. Do psychosocial factors and regional anesthesia affect development of chronic postsurgical pain?

Full description

A patient's psychological profile importantly modulates pain severity, and the overall experience and impact of pain. For instance, catastrophic thinking about pain, including magnification, rumination, and helplessness, is associated with both greater pain severity and impact.

Over the years, regional anesthesia has become an integral part of multimodal pain management for many surgeries. Regional anesthesia (epidural and peripheral nerve blocks) to be associated with superior pain control, reduced time to return of bowel function, shorter intraoperative times, fewer side effects and complications, earlier ambulation and functional exercise capacity post-discharge, lower in-hospital mortality, reduced length-of-stay, improved patient satisfaction, and fewer readmissions.

The investigators aim to use of validated psychosocial surveys and semi-structured interviews to understand the phenotype of patients who will benefit the most from regional anesthesia. The investigators also aim to understand how different patient phenotypes and regional anesthesia affect perioperative opioid consumption, and development of chronic postsurgical pain.

Enrollment: 1,000 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age ≥ 18
• English speaking
• Surgical or procedural patient who will be admitted postoperatively
• Willingness to answer psychosocial survey and/or audio recorded semi-structured interview

Exclusion criteria

-Cognitive dysfunction that precludes communication

Trial design

1,000 participants in 3 patient groups

Thoracic surgery and open abdominal surgery

Description:

Patients who underwent surgery thoracic surgery or open abdominal surgery

Treatment:

Procedure: regional anesthesia

Procedure: no regional anesthesia

Orthopedic surgery

Description:

Patients who underwent orthopedic surgery

Treatment:

Procedure: regional anesthesia

Procedure: no regional anesthesia

Spine surgery

Description:

Patients who underwent spine surgery

Treatment:

Other: acute pain consultation

Other: no acute pain consultation