Acute Pain Predictors of Remote Postoperative Pain Resolution After Hand Surgery

Area of Science:

• Pain Medicine
• Surgical Outcomes
• Clinical Research

Background:

• Chronic postsurgical pain (CPSP) presents a significant global health challenge.
• This study investigated acute pain predictors for long-term outcomes in patients undergoing carpal tunnel release (CTR) or trigger finger release (TFR).

Purpose of the Study:

• To identify acute pain descriptors that effectively predict the time to pain resolution following hand surgery.
• To determine if worst pain intensity on postoperative day (POD) 10 is a reliable predictor of pain cessation.

Main Methods:

• A secondary analysis of a randomized, double-blind, placebo-controlled trial involving adult veterans undergoing CTR or TFR.
• Pain intensity was assessed daily using the Brief Pain Inventory, capturing average, worst, and current pain levels.
• Fifteen acute pain descriptors, including pain scores on POD 10, were analyzed as predictors of time to pain resolution.

Main Results:

• Average pain on POD 10 was the strongest predictor of time to pain cessation.
• Each one-point increase in average pain on POD 10 was associated with a 36.0% reduced rate of pain cessation.
• Average pain on POD 10 (≥3) significantly predicted the development of CPSP at 90 days.

Conclusions:

• Pain severity assessment on POD 10 is vital for identifying patients at high risk for developing CPSP.
• Early identification of high-risk patients allows for timely pain intervention to improve outcomes.
• Further validation in diverse surgical populations is recommended to confirm POD 10 pain assessment as a significant CPSP predictor.