Early warning score useful to prevent post-surgery chronic pain

Conducting an early warning score of patients who are at high risk of developing chronic post-operative pain can help to prevent the problem, according to a new study.

A joint study by German and Dutch researchers investigated which early warning signs are predictive for the development of chronic pain after surgery, which is often difficult to treat, frequently involves long-term opioid use, and affects functional recovery and quality of life.

For this study, which is published in the *British Journal of General Anaesthesia*, the researchers from UMC Utrecht, Erasmus MC and University Hospital Jena, Germany, developed an early warning score in a group of 344 patients at UMC Utrecht.

The validity of the score was tested on a second group from Erasmus MC.

As well as risk factors, such as orthopaedic surgery and preoperative use of opioids, the researchers also found if patients complained of pain 14 days after surgery – especially if this was accompanied by a painful cold sensation – the risk of ongoing pain three months after surgery was significantly increased.

First author Dr Marjelle van Driel said: “The painful cold feeling is an indication that the pain processing system is no longer functioning normally.”

Co-author Dr Winfried Meissner, of the University Hospital Jena, Germany and coordinator of PAIN OUT and the international pain research network involved with this study, added: “This study illustrates the usefulness of simply but specifically following up patients after surgery by means of a questionnaire.”

The authors say the next step in their research is to investigate how the pain processing system responds after surgery.

Driel MEC van, Dijk JFM van, Baart SJ, Meissner W, Huygen FJPM, Rijsdijk M. Development and validation of a multivariable prediction model for early prediction of chronic postsurgical pain in adults: a prospective cohort study. British Journal of Anaesthesia 19 June 2022

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