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Cited by 1,055Anesthesia and Pain ManagementPain Management and Opioid UsePediatric Pain Management Techniques

Predictors of Postoperative Pain and Analgesic Consumption: A Qualitative Systematic Review

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Ip, Hui Yun Vivian, Abrishami, Amir, Peng, Philip W. H., Wong, Jean, Chung, Frances·2009·Anesthesiology
DOI 10.1097/aln.0b013e3181aae87a
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Abstract

Pain is a subjective and multidimensional experience that is often inadequately managed in clinical practice. Effective control of postoperative pain is important after anesthesia and surgery. A systematic review was conducted to identify the independent predictive factors for postoperative pain and analgesic consumption. The authors identified 48 eligible studies with 23,037 patients included in the final analysis. Preoperative pain, anxiety, age, and type of surgery were four significant predictors for postoperative pain. Type of surgery, age, and psychological distress were the significant predictors for analgesic consumption. Gender was not found to be a consistent predictor as traditionally believed. Early identification of the predictors in patients at risk of postoperative pain will allow more effective intervention and better management. The coefficient of determination of the predictive models was less than 54%. More vigorous studies with robust statistics and validated designs are needed to investigate this field of interest.

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  • Preoperative pain is a consistent predictor of chronic postoperative pain across reviews.

    “In several reviews, preoperative pain consistently emerges as an important predictor for the development of chronic postoperative pain1517.”

    From Acceptance and Commitment Therapy for Prevention of Chronic Postsurgical Pain and Opioid Use in At-Risk Veterans: A Pilot Randomized Controlled Study. (2018) · cites this paper as [15]

    The Discussion identifies preexisting pain as a predictor of postoperative pain. But the Inclusion Criteria define the review’s outcome as pain within seven days of surgery, so its finding does not establish prediction of chronic postoperative pain. This paper also cannot establish consistency across several reviews. (LLM, conf=0.88)

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  • Negative affect and pain catastrophizing are risk factors for intense acute postoperative pain and excessive opioid use.

    “Negative affect and pain catastrophizing are also risk factors for intense, acute postoperative pain and excessive opioid use.50–52”

    From Chronic postsurgical pain: From risk factor identification to multidisciplinary management at the Toronto General Hospital Transitional Pain Service (2019) · cites this paper as [50]

    The Discussion reports that negative affect can increase postoperative analgesic consumption and that pain catastrophizing correlates with postoperative pain. The Methodological Quality section also links psychological distress to both pain and analgesic consumption. However, the copy does not establish that both factors predict excessive opioid use specifically; it discusses analgesic consumption more broadly, and notes a study that found no significant link between catastrophizing and analgesic consumption. (LLM, conf=0.84)

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  • In the previous systematic review, quantitative analysis was not possible due to variability in the reporting of measures of associations and study design heterogeneity of the included studies.

    “However, quantitative analysis was not possible due to variability in the reporting of measures of associations and study design heterogeneity of the included studies.”

    From Preoperative predictors of poor acute postoperative pain control: a systematic review and meta-analysis (2019) · cites this paper as [20]

  • A previous systematic review reported a limited number of predictors of poor postoperative pain control including age, anxiety, preoperative pain and surgery type.

    “A previous systematic review reported a limited number of predictors of poor postoperative pain control including age, anxiety, preoperative pain and surgery type.20”

    From Preoperative predictors of poor acute postoperative pain control: a systematic review and meta-analysis (2019) · cites this paper as [20]

  • Sex differences may potentially relate to complex psychosocial and biological factors, such as an increased willingness of women to communicate pain, and subjective differences in pain perception and experience.

    “Sex differences may potentially relate to complex psychosocial and biological factors, such as an increased willingness of women to communicate pain,64 and subjective differences in pain perception and experience.20”

    From Preoperative predictors of poor acute postoperative pain control: a systematic review and meta-analysis (2019) · cites this paper as [20]

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Research works printed but not linked: 6

  1. [2]2. Kiecolt-Glaser JK, Page GG, Marucha PT, MacCallum RC, Glaser R: Psycho- logical influences on surgical recovery. Perspectives from psychoneuroimmunol- ogy. Am Psychol 1998; 53:1209-18
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  5. [80]80. Vlaeyen JWS, Nooyen-Haazen IWCJ, Goossens MEJB, van Breukelen G, Heuts PHTG, Goei H: The role of fear in the cognitive-educational treatment of fibromyalgia, Eighth World Congress on Pain. Edited by Jensen TS, Turner JA, Wiesenfeld-Hallin Z. Seattle, WA, IASP Press, 1997, pp 693-704.
  6. [95]95. Zubieta JK, Heitzeg MM, Smith YR, Bueller JA, Xu K, Xu Y, Koeppe RA, Stohler CS, Goldman D: COMT val158met genotype affects mu-opioid neuro- transmitter responses to a pain stressor. Science 2003; 299:1240-3

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Authors
Ip, H. Y. V., Abrishami, A., Peng, P. W. H., Wong, J., & Chung, F.
Affiliations
  • University Health Network (CA)
  • Research Fellow.
  • Associate Professor.
  • Assistant Professor.
ORCID
Venue
Anesthesiology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2009-09-01
Volume
111
Issue
3
Pages
657-677
ISSN
0003-3022 (ISSN-L)
DOI
10.1097/aln.0b013e3181aae87a
OpenAlex
W1978519915
Cited by
1,055
References
133
Citations by year
2026: 46 · 2025: 58 · 2024: 91 · 2023: 65 · 2022: 71 · 2021: 84 · 2020: 91 · 2019: 72 · 2018: 72 · 2017: 70 · 2016: 59 · 2015: 43 · 2014: 74 · 2013: 57 · 2012: 47
FWCI
5.43
Type
journal article
Language
en
Open access
Licence
public-domain
Locations
  • Anesthesiology (publishedVersion, public-domain)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Keywords
postoperative pain, analgesic use, predictors of postoperative pain, preoperative pain, anxiety, psychological distress, age, type of surgery, gender, pain management
MeSH terms
Adaptation, Psychological, Adult, Age Factors, Aged, Analgesics, Anxiety, Data Interpretation, Statistical, Female, Humans, Male, Middle Aged, Postoperative Pain, Predictive Value of Tests, Prognosis, Sex Factors, Stress, Psychological, Randomized Controlled Trials as Topic

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