Universität zu Köln

Althaus, A., Becker, O. Arranz and Neugebauer, E. (2014). Distinguishing between pain intensity and pain resolution: Using acute post-surgical pain trajectories to predict chronic post-surgical pain. Eur. J. Pain, 18 (4). S. 513 - 522. HOBOKEN: WILEY-BLACKWELL. ISSN 1532-2149

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Abstract

BackgroundHigh intensity of acute post-surgical pain is one of the strongest predictors for chronic post-surgical pain (CPSP). We investigated the predictive power of acute post-surgical pain trajectories and the interplay of pain trajectories and diverse psychosocial risk factors in the development of CPSP. MethodsData from 199 patients were examined using latent growth curve analysis by means of structural equation modelling. This analytical approach was used to explicitly test the mediating role of acute pain trajectories within the association between preoperative psychosocial vulnerability factors and CPSP. ResultsBoth initial pain intensity and pain resolution during the first five post-operative days independently contributed to the prediction of CPSP 6 months after surgery. In terms of vulnerability, anxiety and depression had clear but opposing effects on post-operative pain trajectories. Whereas depressive patients exhibited impaired pain resolution, patients with high anxiety showed better rates of pain resolution after surgery. Both effects on acute pain resolution extended to chronic pain 6 months after surgery. ConclusionsIn this study, we demonstrated that going beyond conventional one-time measurements of acute pain by modelling pain trajectories may substantially enhance research on pain chronification in two ways: First, pain trajectories bear great potential to improve the prediction of CPSP. Second, they represent a meaningful link between psychosocial vulnerability and CPSP because they can be used to uncover mechanisms by which psychosocial vulnerability unfolds. The reported findings suggest that the incidence of CPSP may be reduced by optimizing post-operative pain monitoring.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Althaus, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Becker, O. Arranz UNSPECIFIED UNSPECIFIED UNSPECIFIED Neugebauer, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-442186
DOI:	10.1002/j.1532-2149.2013.00385.x
Journal or Publication Title:	Eur. J. Pain
Volume:	18
Number:	4
Page Range:	S. 513 - 522
Date:	2014
Publisher:	WILEY-BLACKWELL
Place of Publication:	HOBOKEN
ISSN:	1532-2149
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHRONIC POSTOPERATIVE PAIN; RISK-FACTORS; LAPAROSCOPIC CHOLECYSTECTOMY; BREAST-CANCER; SURGERY; ANXIETY; BENIGN Multiple languages Anesthesiology; Clinical Neurology; Neurosciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/44218