PMID- 32675636
OWN - NLM
STAT- MEDLINE
DCOM- 20210308
LR  - 20230721
IS  - 1526-7598 (Electronic)
IS  - 0003-2999 (Print)
IS  - 0003-2999 (Linking)
VI  - 132
IP  - 3
DP  - 2021 Mar 1
TI  - Preoperative Pressure Pain Threshold Is Associated With Postoperative Pain in 
      Short-Stay Anorectal Surgery: A Prospective Observational Study.
PG  - 656-662
LID - 10.1213/ANE.0000000000005072 [doi]
AB  - BACKGROUND: Postoperative pain management is key for patient satisfaction. 
      Pressure pain threshold (PPT) has been studied in some surgical cohorts but has 
      not been studied in relationship to acute postoperative pain in short-stay 
      patients undergoing anorectal surgery. We hypothesized that preoperative finger 
      PPT measurements can identify respective patients with higher postoperative pain. 
      Aiming to understand the relationship with subjective postoperative pain 
      perception, we tested the hypotheses that preoperative PPT is associated with 
      postoperative Visual Analog Scale (VAS) pain scores and correlates with 
      postoperative analgesic consumption in short-stay patients undergoing anorectal 
      surgery. METHODS: We prospectively assessed preoperative PPT in a cohort 
      undergoing anorectal surgery, known as a moderately to severely painful 
      procedure. Linear mixed-effects models were used to assess the relationship with 
      postoperative VAS pain scores at 1 and 3 days as well as 4 weeks postoperatively. 
      Logistic regression was used to study the relationship with additional 
      postoperative analgesic consumption. RESULTS: We studied 128 patients and found 
      that preoperative PPT is significantly associated with postoperative pain (P 
      value for interaction = .025). Logistic regression modeling additionally revealed 
      an association between the preoperative PPT and the need for additional 
      postoperative analgesics, with odds of requiring additional analgesia decreasing 
      by about 10% for each 1-point increase in PPT (odds ratio [OR] = 0.90; 95% 
      confidence interval [CI], 00.81-0.98; P = .012). CONCLUSIONS: Preoperative finger 
      PPT is associated with postoperative pain and might help identify patients who 
      are at risk of developing more severe postoperative pain on anorectal surgery. 
      Especially in ambulatory and short-stay settings, this approach can help to 
      address patients' high variability in pain sensitivity to facilitate appropriate 
      postoperative analgesia, timely discharge, and prevent readmission.
CI  - Copyright (c) 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on 
      behalf of the International Anesthesia Research Society.
FAU - Luedi, Markus M
AU  - Luedi MM
AD  - From the Department of Anaesthesiology and Pain Medicine, Inselspital, Bern 
      University Hospital, University of Bern, Bern, Switzerland.
FAU - Schober, Patrick
AU  - Schober P
AD  - Department of Anaesthesiology, Amsterdam University Medical Centres, Vrije 
      Universiteit Amsterdam, Amsterdam, the Netherlands.
FAU - Hammoud, Bassam
AU  - Hammoud B
AD  - Department of Colorectal Surgery, St Marien-Krankenhaus, Vechta, Germany.
FAU - Andereggen, Lukas
AU  - Andereggen L
AD  - Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland.
FAU - Hoenemann, Christian
AU  - Hoenemann C
AD  - Department of Anaesthesiology, St Marien-Krankenhaus, Vechta, Germany.
FAU - Doll, Dietrich
AU  - Doll D
AD  - Department of Colorectal Surgery, St Marien-Krankenhaus, Vechta, Germany.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Anesth Analg
JT  - Anesthesia and analgesia
JID - 1310650
RN  - 0 (Analgesics)
SB  - IM
CIN - Anesth Analg. 2021 Mar 1;132(3):652-655. PMID: 33591089
MH  - Adult
MH  - Anal Canal/*surgery
MH  - Analgesics/therapeutic use
MH  - Digestive System Surgical Procedures/*adverse effects
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pain Measurement
MH  - Pain Perception
MH  - *Pain Threshold/drug effects
MH  - Pain, Postoperative/diagnosis/drug therapy/*etiology/physiopathology
MH  - Pressure
MH  - Prospective Studies
MH  - Rectum/*surgery
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC7870038
COIS- Conflicts of Interest: See Disclosures at the end of the article.
EDAT- 2020/07/18 06:00
MHDA- 2021/03/09 06:00
PMCR- 2021/02/08
CRDT- 2020/07/18 06:00
PHST- 2020/07/18 06:00 [pubmed]
PHST- 2021/03/09 06:00 [medline]
PHST- 2020/07/18 06:00 [entrez]
PHST- 2021/02/08 00:00 [pmc-release]
AID - 00000539-202103000-00010 [pii]
AID - 10.1213/ANE.0000000000005072 [doi]
PST - ppublish
SO  - Anesth Analg. 2021 Mar 1;132(3):656-662. doi: 10.1213/ANE.0000000000005072.