Understanding the Acute Pain Phenotype in Patients Undergoing Surgery

Purpose

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?

Conditions

  • Acute Pain
  • Chronic Post Operative Pain
  • Opioid Use

Eligibility

Eligible Ages
Over 18 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

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

Study Design

Phase
Study Type
Observational
Observational Model
Cohort
Time Perspective
Prospective

Arm Groups

ArmDescriptionAssigned Intervention
Thoracic surgery and open abdominal surgery Patients who underwent surgery thoracic surgery or open abdominal surgery
  • Procedure: regional anesthesia
    Patients who underwent surgery and received an epidural or peripheral nerve block
  • Procedure: no regional anesthesia
    Patients who underwent surgery and did not received an epidural or peripheral nerve block
Orthopedic surgery Patients who underwent orthopedic surgery
  • Procedure: regional anesthesia
    Patients who underwent surgery and received an epidural or peripheral nerve block
  • Procedure: no regional anesthesia
    Patients who underwent surgery and did not received an epidural or peripheral nerve block
Spine surgery Patients who underwent spine surgery
  • Other: acute pain consultation
    Patients who underwent surgery and had a perioperative (preop, intraop, or postop) acute pain consultation
  • Other: no acute pain consultation
    Patients who underwent surgery and did not have a perioperative (preop, intraop, or postop) acute pain consultation

Recruiting Locations

Brigham and Women's Hospital
Boston, Massachusetts 02115
Contact:
Kristin L Schreiber, MD, PhD

More Details

Status
Recruiting
Sponsor
Brigham and Women's Hospital

Study Contact

Yun-Yun K Chen, MD
617-651-0932
ykchen@mgb.org

Detailed 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.