Predictors of Postoperative Pain

Overview

The purpose of the study is to prove that pain scores generated from painful stimuli applied preoperatively may help identify the inter-individual variability in pain perception.

Full Title of Study: “Predictors of Postoperative Pain Following Abdominal Hysterectomy”

Study Type

  • Study Type: Interventional
  • Study Design
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Supportive Care
    • Masking: None (Open Label)
  • Study Primary Completion Date: March 2014

Detailed Description

Psychological factors and experimental pain models such as as electrical, pressure, heat, or cold stimuli have been identified as predictors of pain intensity and opioid consumption postoperatively. This study will investigate, in addition to the factors described above, the ability of pain scores generated from painful stimuli postoperatively in predicting postoperative pain.

Interventions

  • Device: Thermal Sensory Analyzer (Senselab)
    • Thermal stimuli will be administered to the ventral surface of the dominant forearm and then to the lower abdomen (surgical site)using the Thermal Sensory Analyser. Each thermal testing trial will be separated by approximately 2 min and at a separate site. To measure the thermal pain threshold temperature, The thermode will be applied to the ventral surface of the dominant forearm and the temperature will be increased at 1°C/s from 35 to 50°C. To measure the Suprathreshold Thermal Pain Intensity and unpleasantness, Stimulus responses for noxious heat stimuli will be performed by applying phasic heat stimuli at 8 different temperatures (35, 43, 44, 45, 46, 47, 48, and 49°C).

Arms, Groups and Cohorts

  • No Intervention: Patients undergoing hysterectomy

Clinical Trial Outcome Measures

Primary Measures

  • pain scores from IV insertion
    • Time Frame: 15 minutes prior to induction

Secondary Measures

  • Anxiety
    • Time Frame: 24 to 48 hours before surgery
  • Pain from thermal stimuli
    • Time Frame: 24 to 48 hours before surgery
    • Pain from thermal stimuli will be measure at two sites: site of surgery and at the forearm.
  • Suprathreshold Thermal pain intensity
    • Time Frame: 24 to 48 hours before surgery
    • Suprathreshold Thermal pain intensity will be recorded at two site: site of surgery and forearm
  • suprathreshold thermal unpleasantness intensity
    • Time Frame: 24 to 48 hours before surgery
  • Expectation about pain
    • Time Frame: 24 to 48 hours before surgery
  • postoperative pain
    • Time Frame: within 1-2 hours after arrival to recovery room; and at 12 hours, 24 hours, 36 hours and 48 hours after surgery
    • Postoperative pain will be measured upon arrival to the Post Anesthesia Care Unit (PACU)before morphine consumption and after morphine consumption, at rest and at movement.
  • Morphine consumption
    • Time Frame: within 1-2 hours after arrival to recovery room; and at 12 hours, 24 hours, 36 hours and 48 hours after surgery

Participating in This Clinical Trial

Inclusion Criteria

  • Patients undergoing abdominal hysterectomy through a pfannenstiel incision
  • American Society of Anesthesiologists (ASA)Class I-III

Exclusion Criteria

  • Patients with a history of psychiatric disease
  • Diabetic or alcoholic patients who may have impaired sensation due peripheral neuropathies
  • chronic opioid or nonsteroidal antiinflammatory drug use
  • chronic pain conditions

Gender Eligibility: Female

Minimum Age: 35 Years

Maximum Age: 65 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • American University of Beirut Medical Center
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Marie T Aouad, MD, Principal Investigator, American University of Beirut Medical Center

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