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Flagging the pain: preventing the burden of chronic pain by identifying and treating risk factors in acute pain

Published online by Cambridge University Press:  02 June 2005

E. A. Shipton
Affiliation:
University of Otago, Christchurch School of Medicine and Health Sciences, Department of Anaesthesia, Christchurch, New Zealand
B. Tait
Affiliation:
University of Otago, Christchurch School of Medicine and Health Sciences, Department of Anaesthesia, Christchurch, New Zealand
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Extract

Summary

Chronic pain represents a major public health problem that impacts negatively on quality-of-life issues and healthcare costs. Unrelieved acute post-traumatic and postoperative pains are risk factors in the development of chronic pain, although psychological and environmental factors are at work as well. Flagging pain (blue, yellow and red flags) helps to identify risk factors in acute pain that need attention to avoid the transition from acute postoperative pain to acute persistent and then on to chronic pain. This offers a unique opportunity for preventative medicine.

Type
Review
Copyright
© 2005 European Society of Anaesthesiology

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References

Eriksen J, Jensen MK, Sjogren P, et al. Epidemiology of chronic non-malignant pain in Denmark. Pain 2003; 106: 221228.Google Scholar
Elliott AM, Smith BH, Hannaford PC, et al. The course of chronic pain in the community: results of a 4-year follow-up study. Pain 2002; 99: 299307.Google Scholar
Manchikanti L, Staats PS, Singh V, et al. Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician 2003; 6: 381.Google Scholar
Van Den Kerkhof EG, Hopman WM, Towheed TE, et al. The impact of sampling and measurement on the prevalence of self-reported pain in Canada. Pain Res Manag 2003; 8: 157163.Google Scholar
Blyth FM, March LM, Brnabic AJM, et al. Chronic pain in Australia: a prevalence study. Pain 2001; 89: 127134.Google Scholar
Walker BF, Muller R, Grant WD. Low back pain in Australian adults: prevalence and associated disability. Manipulat Physiol Ther 2004; 27: 238244.Google Scholar
Stephens J, Laskin B, Pashos C, et al. The burden of acute postoperative pain and the potential role of the COX-2-specific inhibitors. Rheumatology (Oxford) 2003; 42 (Suppl 3): 4052.Google Scholar
Brown AK, Christo PJ, Wu CL. Strategies for postoperative pain management. Best Pract Res Clin Anaesthesiol 2004; 18: 703717.Google Scholar
Crombie IK, Davies HT, Macrae WA. Cut and thrust: antecedent surgery and trauma among patients attending a chronic pain clinic. Pain 1998; 76: 167171.Google Scholar
Kalkman CJ, Visser K, Moen J, Bonsel GJ, Grobbee DE, Moons KG. Preoperative prediction of severe postoperative pain. Pain 2003; 105: 415423.Google Scholar
Whelan CT, Jin L, Meltzer D. Pain and satisfaction with pain control in hospitalized medical patients: no such thing as low risk. Arch Intern Med 2004; 164: 175180.Google Scholar
Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg 2003; 97: 534540.Google Scholar
Perkins FM, Kehlet H. Chronic pain as an outcome of surgery. A review of predictive factors. Anesthesiology 2000; 93: 11231133.Google Scholar
Breivik H. How to implement an acute pain service. Best Pract Res Clin Anaesthesiol 2002; 16: 527547.Google Scholar
Eriksen J, Ekholm O, Sjogren P, Rasmussen NK. Development of and recovery from long-term pain. A 6-year follow-up study of a cross-section of the adult Danish population. Pain 2004; 108: 154162.Google Scholar
Rustoen T, Wahl AK, Hanestad BR, et al. Prevalence and characteristics of chronic pain in the general Norwegian population. Eur J Pain 2004; 8: 555565.Google Scholar
Thomas T, Robinson C, Champion D, et al. Prediction and assessment of the severity of post-operative pain and of satisfaction with management. Pain 1998; 75: 177185.Google Scholar
Glennon JP, Ng YL, Setchell DJ, Gulabivala K. Prevalence of and factors affecting postpreparation pain in patients undergoing two-visit root canal treatment. Int Endod J 2004; 37: 2937.Google Scholar
Slappendel R, Weber EW, Bugter ML, Dirksen R. The intensity of preoperative pain is directly correlated with the amount of morphine needed for postoperative analgesia. Anesth Analg 1999; 88: 146148.Google Scholar
Bruce J, Drury N, Poobalan AS, et al. The prevalence of chronic chest and leg pain following cardiac surgery: a historical cohort study. Pain 2003; 104: 265273.Google Scholar
Peolsson A, Hedlund R, Vavruch L, Oberg B. Predictive factors for the outcome of anterior cervical decompression and fusion. Eur Spine J 2003; 12: 274280.Google Scholar
Turner JA, Ciol MA, Von Korff M, Berger R. Prognosis of patients with new prostatitis/pelvic pain syndrome episodes. J Urol 2004; 172: 538541.Google Scholar
Flor H. Visualisation of phantom- and back pain using imaging techniques. Implication for treatment. Orthopade 2004; 33: 553557.Google Scholar
Brander VA, Stulberg SD, Adams AD, et al. Predicting total knee replacement pain: a prospective, observational study. Clin Orthop 2003; 416: 2736.Google Scholar
Harden RN, Bruehl S, Stanos S, et al. Prospective examination of pain-related and psychological predictors of CRPS-like phenomena following total knee arthroplasty: a preliminary study. Pain 2003; 106: 393400.Google Scholar
Granot M, Lowenstein L, Yarnitsky D, et al. Postcesarean section pain prediction by preoperative experimental pain assessment. Anesthesiology 2003; 98: 14221426.Google Scholar
Werner MU, Duun P, Kehlet H. Prediction of postoperative pain by preoperative nociceptive responses to heat stimulation. Anesthesiology 2004; 100: 115119.Google Scholar
Mitra S, Sinatra RS. Perioperative management of acute pain in the opioid-dependent patient. Anesthesiology 2004; 101: 212227.Google Scholar
Chung F, Ritchie E, Su J. Postoperative pain in ambulatory surgery. Anesth Analg 1997; 85: 808816.Google Scholar
Horvath KJ. Postoperative recovery at home after ambulatory gynecologic laparoscopic surgery. J Perianesth Nurs 2003; 18: 324334.Google Scholar
Fassoulaki A, Patris K, Sarantopoulos C, Hogan Q. The analgesic effect of gabapentin and mexiletine after breast surgery for cancer. Anesth Analg 2002; 95: 985991.Google Scholar
Mikkelsen T, Werner MU, Lassen B, Kehlet H. Pain and sensory dysfunction 6 to 12 months after inguinal herniotomy. Anesth Analg 2004; 99: 146151.Google Scholar
Mendoza TR, Chen C, Brugger A, et al. The utility and validity of the modified brief pain inventory in a multiple-dose postoperative analgesic trial. Clin J Pain 2004; 20: 357362.Google Scholar
Kalso E, Mennander S, Tasmuth T, Nilsson E. Chronic post-sternotomy pain. Acta Anaesthesiol Scand 2001; 45: 935939.Google Scholar
Gottschalk A, Freitag M, Tank S, et al. Quality of postoperative pain using an intraoperatively placed epidural catheter after major lumbar spinal surgery. Anesthesiology 2004; 101: 175180.Google Scholar
Jensen MK, Andersen C. Can chronic poststernotomy pain after cardiac valve replacement be reduced using thoracic epidural analgesia? Acta Anaesthesiol Scand 2004; 48: 871874.Google Scholar
Hunter J. Demographic variables and chronic pain. Clin J Pain 2001; 17 (Suppl 4): S14S19.Google Scholar
Sondenaa K, Nesvik I, Breivik K, Korner H. Long-term follow-up of 1059 consecutive primary and recurrent inguinal hernias in a teaching hospital. Eur J Surg 2001; 167: 125129.Google Scholar
McLean SA, Clauw DJ. Predicting chronic symptoms after an acute ‘stressor’ – lessons learned from 3 medical conditions. Med Hypoth 2004; 63: 653658.Google Scholar
Svensson I, Sjostrom B, Haljamae H. Influence of expectations and actual pain experiences on satisfaction with postoperative pain management. Eur J Pain 2001; 5: 125133.Google Scholar
Cheng SF, Foster RL, Hester NO. A review of factors predicting children's pain experiences. Issues Compr Pediatr Nurs 2003; 26: 203216.Google Scholar
Ozalp G, Sarioglu R, Tuncel G, et al. Preoperative emotional states in patients with breast cancer and postoperative pain. Acta Anaesthesiol Scand 2003; 47: 2629.Google Scholar
Ciccone DS, Just N. Pain expectancy and work disability in patients with acute and chronic pain: a test of the fear avoidance hypothesis. J Pain 2001; 2: 181194.Google Scholar
Mantyselka PT, Turunen JH, Ahonen RS, Kumpusalo EA. Chronic pain and poor self-rated health. JAMA 2003; 290: 24352442.Google Scholar
Breivik H. Postoperative pain: toward optimal pharmacological and epidural analgesia. In: Giamberardino MA, ed. Pain 2002 – An Updated Review. Seattle: IASP Press, 2002: 337349.
Skinner HB. Multimodal acute pain management. Am J Orthop 2004; 33 (Suppl 5): 59.Google Scholar
Stevens B, Katz J, Costello J, et al. Impact of preoperative education on pain outcomes after coronary artery bypass graft surgery. Pain 2004; 109: 7385.Google Scholar
Good M, Stanton-Hicks M, Grass JA, et al. Pain after gynecologic surgery. Pain Manag Nurs 2000; 1: 96104.Google Scholar
Mamie C, Bernstein M, Morabia A, et al. Are there reliable predictors of postoperative pain? Acta Anaesthesiol Scand 2004; 48: 234242.Google Scholar
Rakel B, Herr K. Assessment and treatment of postoperative pain in older adults. J Perianesth Nurs 2004; 19: 194208.Google Scholar
Soler-Company E, Faus-Soler M, Montaner-Abasolo M, et al. Factors affecting postoperative pain. Rev Esp Anestesiol Reanim 2001; 48: 163170.Google Scholar
Dura-Navarro R, De Andres-Ibanez J. A review of clinical evidence supporting techniques to prevent chronic postoperative pain syndromes. Rev Esp Anestesiol Reanim 2004; 51: 205212.Google Scholar
Yegin A, Erdogan A, Kayacan N, Karsli B. Early postoperative pain management after thoracic surgery; pre- and postoperative versus postoperative epidural analgesia: a randomised study. Eur J Cardiothorac Surg 2003; 24: 420424.Google Scholar
Caumo W, Schmidt AP, Schneider CN, et al. Preoperative predictors of moderate to intense acute postoperative pain in patients undergoing abdominal surgery. Acta Anaesthesiol Scand 2002; 46: 12651271.Google Scholar
Taillefer M, Lanctôt H, Carrier M, et al. Prevalence, characteristics and predictors of chronic pain following cardiac surgery: a cross-sectional study. J Pain 2004; 5: S45.Google Scholar
Thonse R, Ashford RU, Williams TI, Harrington P. Differences in attitudes to analgesia in post-operative limb surgery put patients at risk of compartment syndrome. Injury 2004; 35: 290295.Google Scholar
Williams RA, Pruitt SD, Doctor JN, et al. The contribution of job satisfaction to the transition from acute to chronic low back pain. Arch Phys Med Rehab 1998; 79: 366374.Google Scholar
Bhandari M, Sprague S, Hanson B, et al. Health-related quality of life following operative treatment of unstable ankle fractures: a prospective observational study. J Orthop Trauma 2004; 18: 338345.Google Scholar
Sjoling M, Nordahl G, Olofsson N, Asplund K. The impact of preoperative information on state anxiety, postoperative pain and satisfaction with pain management. Patient Educ Couns 2003; 5: 169176.Google Scholar
Garretson S. Benefits of pre-operative information programmes. Nurs Stand 2004; 18: 3337.Google Scholar
Reurer M, Hueppe M, Klotz KF, et al. Detection of causal relationships between factors influencing adverse side-effects from anaesthesia and convalescence following surgery: a path analytical approach. Eur J Anaesthesiol 2004; 21: 434442.Google Scholar
La Montagne LL, Hepworth JT, Cohen F, Salisbury MH. Cognitive-behavioral intervention effects on adolescents' anxiety and pain following spinal fusion surgery. Nurs Res 2003; 52: 183190.Google Scholar
Giraudet-Le Quintrec JS, Coste J, Vastel L, et al. Positive effect of patient education for hip surgery: a randomized trial. Clin Orthop 2003; 414: 112120.Google Scholar
Berge DJ, Dolin SJ, Williams AC, Harman R. Pre-operative and post-operative effect of a pain management programme prior to total hip replacement: a randomized controlled trial. Pain 2004; 110: 3339.Google Scholar
Ikonomidou E, Rehnstrom A, Naesh O. Effect of music on vital signs and postoperative pain. Assoc Oper Room Nurs J 2004; 80: 269274.Google Scholar
Krenzischek DA, Windle P, Mamaril M. A survey of current perianesthesia nursing practice for pain and comfort management. J Perianesth Nurs 2004; 19: 138149.Google Scholar
Kehlet H, Wilmore DW. Mutlimodal strategies to improve surgical outcome. Am J Surg 2002; 183: 630641.Google Scholar
Cerfolio RJ, Price TN, Bryant AS, et al. Intracostal sutures decrease the pain of thoracotomy. Ann Thorac Surg 2003; 76: 407411.Google Scholar
Persson K, Ostman M. The Swedish version of the PACU-Behavioural Pain Rating Scale: a reliable method of assessing postoperative pain? Scand J Caring Sci 2004; 18: 304309.Google Scholar
Lanser P, Gesell S. Pain management: the fifth vital sign. Healthc Benchmarks 2001; 8: 6870.Google Scholar
Geissler B, Neugebauer E, Angster R, Witte Dagger J. Quality management during postoperative pain therapy. Chirurg 2004; 75: 687793.Google Scholar
Power I, Barratt S. Analgesic agents for the postoperative period. Nonopioids. Surg Clin North Am 1999; 79: 275295.Google Scholar
Pogatzki EM, Niemeier JS, Sorkin LS, Brennan TJ. Spinal glutamate receptor antagonists differentiate primary and secondary mechanical hyperalgesia caused by incision. Pain 2003; 105: 97107.Google Scholar
Carli F, Mayo N, Klubien K, et al. Epidural analgesia enhances functional exercise capacity and health-related quality of life after colonic surgery: results of a randomized trial. Anesthesiology 2002; 97: 540549.Google Scholar
Wu CL, Raja SN. Optimising postoperative analgesia. Anesthesiology 2002; 97: 533534.Google Scholar
Moline BM. Pain management in the ambulatory surgical population. J Perianesth Nurs 2001; 16: 388398.Google Scholar
Kamming D, Chung F, Williams D, et al. Pain management in ambulatory surgery. J Perianesth Nurs 2004; 19: 174182.Google Scholar
Katz J, Cohen L. Preventive analgesia is associated with reduced pain disability 3 weeks but not 6 months after major gynecologic surgery by laparotomy. Anesthesiology 2004; 101: 169174.Google Scholar
Stadler M, Schlander M, Braeckman M, et al. A cost-utility and cost-effectiveness analysis of an acute pain service. J Clin Anesth 2004; 16: 159167.Google Scholar
Moiniche S, Kehlet H, Dahl JB. A qualitative and quantitative systematic review of preemptive analgesia for postoperative pain relief: the role of timing of analgesia. Anesthesiology 2002; 93: 725741.Google Scholar
Stamer UM, Bayerer B, Stüber F. Genetics and variability in opioid response. Eur J Pain 2005; 9: 101104.Google Scholar
Mogil JS, Wilson SG, Bon K, et al. Heritability of nociception I: responses of 11 inbred mouse strains on 12 measures of nociception. Pain 1999; 80: 6782.Google Scholar
Meunier A, Braz J, Cesselin F, et al. From inflammation to pain: experimental gene therapy. Med Sci 2004; 20: 325330.Google Scholar
Siddall PJ, Cousins MJ. Persistent pain as a disease entity: implications for clinical management. Anesth Analg 2004; 99: 510520.Google Scholar
Kehlet H, Dahl JB. Anaesthesia, surgery, and challenges in postoperative recovery. Lancet 2003; 362: 19211928.Google Scholar
Kehlet H. Effect of postoperative pain treatment on outcome – current status and future strategies. Langenbeck Arch Surg 2004; 389: 244249.Google Scholar