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Chronic postoperative pain (CPP) is typically defined as pain persisting for 3 months or more after surgery[1]. CPP is a common and increasingly prevalent morbidity, leading to long-term psychological issues, reduced quality of life, and impaired functionality[2]. To reduce the incidence of CPP, high-risk patients are identified, and various surgical techniques, pharmacological agents, and regional anesthesia techniques are employed[3].
The primary aim of our study is to scale chronic pain at 1 hour, 3 months, and 1 year post-nephrectomy using the Numeric Rating Scale (NRS), ranging from 0 to 10. The secondary aim is to evaluate the effects of factors influencing chronic postoperative pain on the NRS scores.
Patients gender, age, height(m), weight(kg), body mass index(kg/m2), diagnosis, smoking and alcohol history, comorbidities, surgical technique and duration, complications, lymph node dissection, thrombectomy, adrenalectomy, amount of bleeding(cc), need for blood transfusion, need for intensive care, analgesia technique used, amount of opioids and non-opioid analgesics used perioperatively, amount of vasopressors used, heart rate(bpm) and mean arterial pressure(mmHg) at induction, post-intubation, post-extubation, and 1 hour postoperatively, presence of postoperative pain, chronic analgesic use history(more than 3 uses per week), presence of fibromyalgia, frequent urinary tract infections, diagnosed with central sensitization disorders, bruxism, depression-panic attacks, allergic asthma, irritable bowel syndrome, and migraines will be recorded. The effects of these factors on NRS scores at 1 hour, 3 months, and 1 year postoperatively will be examined.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Painfull: patients with Numeric Rating Score equal or higher than 4 | The patients are asked to rate their pain according to the Numeric Rating Scale (0=no pain; 10=worse possible pain), and patients with NRS equal or higher than 4 are defined as "painfull". |
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| Pain-free: patients with Numeric Rating Score lower than 4 | The patients are asked to rate their pain according to the Numeric Rating Scale (0=no pain; 10=worse possible pain), and patients with NRS lower than 4 are defined as "pain-free". |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Numeric Rating Scale | Diagnostic Test | The patients are asked to rate their pain according to the Numeric Rating Scale (0=no pain; 10=worse possible pain). |
|
| Measure | Description | Time Frame |
|---|---|---|
| NRS 1 hour | The patients are asked to rate their pain according to the Numeric Rating Scale (0=no pain; 10=worse possible pain). Patients with NRS equal or higher than 4 are defined as painfull; and, patients with NRS lower than 4 are defined as pain-free | 1 hour after the end of the surgery |
| NRS 3 months | The patients are asked to rate their pain according to the Numeric Rating Scale (0=no pain; 10=worse possible pain). Patients with NRS equal or higher than 4 are defined as painfull; and, patients with NRS lower than 4 are defined as pain-free | 3 months after the surgery |
| NRS 1 year | The patients are asked to rate their pain according to the Numeric Rating Scale (0=no pain; 10=worse possible pain). Patients with NRS equal or higher than 4 are defined as painfull; and, patients with NRS lower than 4 are defined as pain-free | 1 year after the surgery |
| Measure | Description | Time Frame |
|---|---|---|
| age | Age of the patiens as years | At the time of preoperative assesment |
| height | Height of the patiens as meter | At the time of preoperative assesment |
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Inclusion Criteria: -Patients aged 18-90 years,
Exclusion Criteria:
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Patients aged 18-90 years, ASA I-IV, undergoing elective nephrectomy under general anesthesia will be included in the study.
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| Name | Affiliation | Role |
|---|---|---|
| Aylin Nizamoglu, Doctor | Istanbul Univerisity-Cerrahpasa Cerrahpasa Faculty of Medicine | Study Director |
| Safak E Erbabacan, associate professor | Istanbul Univerisity-Cerrahpasa Cerrahpasa Faculty of Medicine | Study Chair |
| Fatis Altindas, Professor | Istanbul Univerisity-Cerrahpasa Cerrahpasa Faculty of Medicine | Study Chair |
| Ilayda Bilgili Altuntas, Physician | Istanbul Univerisity-Cerrahpasa Cerrahpasa Faculty of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Istanbul University-Cerrahpasa | Istanbul | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34121077 | Background | Sharma LR, Schaldemose EL, Alaverdyan H, Nikolajsen L, Chen D, Bhanvadia S, Komen H, Yaeger L, Haroutounian S. Perioperative factors associated with persistent postsurgical pain after hysterectomy, cesarean section, prostatectomy, and donor nephrectomy: a systematic review and meta-analysis. Pain. 2022 Mar 1;163(3):425-435. doi: 10.1097/j.pain.0000000000002361. |
| Label | URL |
|---|---|
| Perioperative factors associated with persistent postsurgical pain after hysterectomy, cesarean section, prostatectomy, and donor nephrectomy: A systematic review and meta-analysis | View source |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| D059350 | Chronic Pain |
| D059787 | Acute Pain |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| BMI | body mass index of the patiens as kg/m2 | At the time of preoperative assesment |
| smoking | Data of the patient if they are smoking or not | At the time of preoperative assesment |
| Amount of opioid and non-opioid analgesics used perioperatively | Amount of opioid and non-opioid analgesics used perioperatively | At the time of perioperative assesment |
| Gender | Woman or man | At the time of preoperative assesment |
| Comorbidities | hipertension, diabetus mellitus, asthma or cardiac disease etc. | At the time of preoperative assesment |
| surgical technique | radical or partial nephrectomy and open or laparoscopic nephrectomy | At the time of perioperative assesment |
| surgical duration | How long does the surgery take in minutes? | The time recorded at the end of the surgery will be reported |
| additional procedures next to the nephrectomy | lymph node dissection, thrombectomy, adrenalectomy procedures used | At the time of perioperative assesment |
| need for blood transfusion | How many blood product tranfusions were required? | At the time of perioperative assesment |
| need for intensive care units | Whether there is a need for intensive care after surgery | At the time of postoperative assesment, the data evaluated at the end of the surgery will be reported |
| Analgesia technique | Epidural analgesia or intravenous analgesia was used as analgesic technique | At the time of perioperative assesment |
| Amount of vasopressors used | Amount of vasopressors used at the perioperative period | At the time of perioperative assesment |
| Value of postoperative acute pain score on NRS score | Value of postoperative acute pain score on NRS score(0:no pain, 10:the worst pain imaginable) | 1 hour postoperative period |
| Chronic analgesic use history | More than 3 uses per a week | 1 year before the operation |
| Clinical conditions that will be reported under the title of central sensitization disorder | Presence of fibromyalgia, frequent urinary tract infection, bruxism, diagnosed with depression-panic attack, allergic asthma, irritable bowel syndrome and migraines will be recorded. | At the time of preoperative assesment |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |