Perioperative optimization in patients with chronic pain: a reflective review
DOI:
https://doi.org/10.24054/cbs.v3i2.4045Keywords:
Chronic pain, surgery, perioperative care, surgical prevention, patient care teamAbstract
Chronic pain is an intersectional condition whose impact has gained more attention following the COVID-19 pandemic. Preoperative optimization in these patients presents logistical, social, and economic challenges. This study explores the implementation of Perioperative Optimization Programs (POP) as an integrated approach to improve care and outcomes for these patients. A reflective review of various articles available in scientific databases, action plans, and protocols in both Spanish and English was conducted to assess the importance of perioperative optimization and identify existing evidence for optimizing the preoperative state in chronic pain patients. The implementation of an integrated perioperative approach improves recovery and reduces risks in chronic pain patients. These programs are essential to optimizing surgical care and promoting a faster, safer recovery.
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References
Alorfi, N. M. (2023). Pharmacological methods of pain management: Narrative review of medication used. International Journal of General Medicine, 16, 3247–3256. https://doi.org/10.2147/IJGM.S419239
Aronson, S., Martin, G., Gulur, P., Lipkin, M. E., Lagoo-Deenadayalan, S. A., Mantyh, C. R., et al. (2020). Preoperative optimization: A continued call to action. Anesthesia & Analgesia, 130(4), 808–810. https://doi.org/10.1213/ANE.0000000000004492
Bartels, K., Conroy, J. M., & Gan, T. J. (2024). Perioperative quality improvement: Opportunities and challenges for pragmatic trial designs. Anesthesia & Analgesia, 138(3), 514–516. https://doi.org/10.1213/ANE.0000000000006838
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4(6), 561–571.
Belzak, L., & Halverson, J. (2018). Evidence synthesis - The opioid crisis in Canada: A national perspective. Health Promotion and Chronic Disease Prevention in Canada, 38(6), 224–233. https://doi.org/10.24095/hpcdp.38.6.02
Boersma, K. (2003). Early identification of patients at risk of developing a persistent back problem: The predictive validity of the Örebro Musculoskeletal Pain Questionnaire. The Clinical Journal of Pain, 19(2), 80–86.
Cashin, A. G., Wand, B. M., O’Connell, N. E., Lee, H., Rizzo, R. R., Bagg, M. K., et al. (2023). Pharmacological treatments for low back pain in adults: An overview of Cochrane Reviews. Cochrane Database of Systematic Reviews, 2023(4). https://doi.org/10.1002/14651858.CD013815.pub2
Chung, F., Yegneswaran, B., Liao, P., Chung, S. A., Vairavanathan, S., Islam, S., Khajehdehi, A., & Shapiro, C. M. (2008). STOP questionnaire: A tool to screen patients for obstructive sleep apnea. Anesthesiology, 108(5), 812–821.
Cleeland, C. S., & Ryan, K. M. (1994). Pain assessment: Global use of the Brief Pain Inventory. Annals of the Academy of Medicine, Singapore, 23(2), 129–138.
Doan, L. V., & Blitz, J. (2020). Preoperative assessment and management of patients with pain and anxiety disorders. Current Anesthesiology Reports, 10(1), 28–34. https://doi.org/10.1007/s40140-020-00367-9
Doctors of BC. (2021). Results show collaborative initiative improves surgical outcomes and experiences. https://www.doctorsofbc.ca/news/2021/results-show-collaborative-initiative-improves-surgical-outcomes-experiences
Dowell, D., Ragan, K. R., Jones, C. M., Baldwin, G. T., & Chou, R. (2022). CDC clinical practice guideline for prescribing opioids for pain. MMWR Recommendations and Reports, 71(3), 1–95. https://doi.org/10.15585/mmwr.rr7103a1
Gibson, E., & Sabo, M. T. (2018). Can pain catastrophizing be changed in surgical patients? A scoping review. Canadian Journal of Surgery, 61(5), 311–318.
Gulur, P., & Nelli, A. (2020). Preoperative optimization of chronic pain patients undergoing surgery. Techniques in Orthopaedics, 35(1), 19–24. https://doi.org/10.1097/BTO.0000000000000433
Hara, S., Andresen, H., Solheim, O., Carlsen, S. M., Sundstrøm, T., Lønne, G., et al. (2022). Effect of spinal cord burst stimulation vs placebo stimulation on disability in patients with chronic radicular pain after lumbar spine surgery. JAMA, 328(15), 1506. https://doi.org/10.1001/jama.2022.18231
Health Canada. (2021). An action plan for pain in Canada. https://www.canada.ca/content/dam/hc-sc/documents/corporate/about-health-canada/public-engagement/external-advisory-bodies/canadian-pain-task-force/report-2021-rapport/report-rapport-2021-eng.pdf
Kim, B. R., Yoon, S. H., & Lee, H. J. (2023). Practical strategies for the prevention and management of chronic postsurgical pain. Korean Journal of Pain, 36(2), 149–162. https://doi.org/10.3344/kjp.23080
Kychenthal Loyola, C., Vega Pérez, E., & Elgueta Le-Beuffe, F. (2020, November 24). Consideraciones en pacientes con dolor crónico sometidos a cirugía. Revista de Cirugía (México), 72(6). https://doi.org/10.35687/s2452-45492020006978
Laporte, M., Keller, H. H., Payette, H., Allard, J. P., Duerksen, D. R., Bernier, P., Jeejeebhoy, K. N., & Gramlich, L. (2015). Validity and reliability of the new Canadian Nutrition Screening Tool in the ‘real-world’ hospital setting. European Journal of Clinical Nutrition, 69(5), 558–564.
Macgregor, C., Walumbe, J., Tulle, E., Seenan, C., & Blane, D. N. (2023). Intersectionality as a theoretical framework for researching health inequities in chronic pain. British Journal of Pain, 17(5), 479–490. https://doi.org/10.1177/20494637231188583
Mc Loughlin, S., Fraidenraij, U., & Álvarez, A. O. (2021). Programas de optimización perioperatoria, Enhanced Recovery y Fast-track: ¿Por qué están en auge? ¿Qué son realmente y cómo se implementan en la práctica? Revista Argentina de Cirugía, 113(2), 159–168. https://doi.org/10.25132/raac.v113.n2.eras02mcs.ei
Mills, S., Nicolson, K. P., & Smith, B. H. (2019). Chronic pain: A review of its epidemiology and associated factors in population-based studies. British Journal of Anaesthesia, 123(2), e273–e283. https://doi.org/10.1016/j.bja.2019.03.023
Moore, R. A., Wiffen, P. J., Derry, S., & Rice, A. S. (2014). Gabapentin for chronic neuropathic pain and fibromyalgia in adults. In R. A. Moore (Ed.), Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd. https://doi.org/10.1002/14651858.CD007938.pub3
Mrázová, B., et al. (2023). Prehabilitation as an integral procedure in predictive, preventive, and personalized medicine and modern and effective healthcare. In H. Podbielska & M. Kapalla (Eds.), Predictive, preventive, and personalised medicine: From bench to bedside Springer. https://doi.org/10.1007/978-3-031-34884-6_4
Nahin, R. L., Feinberg, T., Kapos, F. P., & Terman, G. W. (2023). Estimated rates of incident and persistent chronic pain among US adults, 2019-2020. JAMA Network Open, 6(5), e2313563. https://doi.org/10.1001/jamanetworkopen.2023.13563
Newman, A., & Thorn, E. (2022). Intersectional identity approach to chronic pain disparities using latent class analysis. Pain, 163(4), e547–e556. https://doi.org/10.1097/j.pain.0000000000002407
Nicholas, M., Vlaeyen, J. W. S., Rief, W., Barke, A., Aziz, Q., Benoliel, R., et al. (2019). The IASP classification of chronic pain for ICD-11: Chronic primary pain. Pain, 160(1), 28–37. https://doi.org/10.1097/j.pain.0000000000001390
Patel, J., Snyder, K., & Brooks, A. K. (2024). Perioperative pain optimization in the age of the opioid epidemic. Current Opinion in Anaesthesiology, 37(3), 279–284. https://doi.org/10.1097/ACO.0000000000001370
PEER Guideline Committee. (2022). PEER simplified chronic pain guideline: Management of chronic low back, osteoarthritic, and neuropathic pain in primary care. Canadian Family Physician, 68(3), 179–190. https://doi.org/10.46747/cfp.6803179
Raja, S. N., Carr, D. B., Cohen, M., Finnerup, N. B., Flor, H., Gibson, S., et al. (2020). The revised International Association for the Study of Pain definition of pain: Concepts, challenges, and compromises. Pain, 161(9), 1976–1982. https://doi.org/10.1097/j.pain.0000000000001939
Roldán, C. (n.d.). Prehabilitación: La mejor rehabilitación. FisioSaludable. https://fisiosaludable.com/publicaciones/articulos/399-prehabilitacion-la-mejor-rehabilitacion
Sá, K. N., Moreira, L., Baptista, A. F., Yeng, L. T., Teixeira, M. J., Galhardoni, R., et al. (2019). Prevalence of chronic pain in developing countries: Systematic review and meta-analysis. Pain Reports, 4(6), e779. https://doi.org/10.1097/PR9.0000000000000779
Samaniego Brambilla, M. E., Quiroz González, A. G., González Toledo, J. I., & Cedeño Álava, A. O. (2024). Gestión integral del paciente quirúrgico: Optimización preoperatoria y cuidados postoperatorios en cirugía general. Dominio de las Ciencias, 10(1), 940–951. https://doi.org/10.23857/dc.v10i1.3754
Sánchez Corrales, P., & Vargas Blanco, E. (2020). Superación de barreras en la implementación de los protocolos ERAS: Aspectos nutricionales. Revista de Nutrición Clínica y Metabolismo, 3(1), 100–107. https://doi.org/10.35454/rncm.v3n1.022
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097.
Sullivan, M. J. L., Bishop, S. R., & Pivik, J. (1995). The Pain Catastrophizing Scale: Development and validation. Psychological Assessment, 7(4), 524–532.
Tidmarsh, L. V., Harrison, R., & Finlay, K. A. (2024). Prehabilitation: The underutilised weapon for chronic pain management. British Journal of Pain, 18(4), 354–364. https://doi.org/10.1177/20494637241250239
U.S. Department of Health and Human Services. (2019). Pain management best practices inter-agency task force report: Updates, gaps, inconsistencies, and recommendations. https://www.hhs.gov/sites/default/files/pmtf-final-report-2019-05-23.pdf
Varrassi, G., Müller-Schwefe, G., Pergolizzi, J., Orónska, A., Morlion, B., Mavrocordatos, P., et al. (2010). Pharmacological treatment of chronic pain — The need for CHANGE. Current Medical Research and Opinion, 26(5), 1231–1245. https://doi.org/10.1185/03007991003689175
Wilson, P. R. (2020). Preoperative optimization of the chronic pain patient. In H. B. McAnally, L. W. Freeman, & B. Darnall (Eds.), Enhanced recovery before surgery (pp. 860–861). Oxford University Press. https://doi.org/10.1093/pm/pnz272
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