How perioperative processes and patient-reported outcomes contribute to persistent postoperative opioid use: A cohort study linking clinical and health claims data.

Background: Opioid analgesics play a major role in perioperative pain management, yet their use can lead to persistent postoperative opioid use (PPOU), with significant societal and health costs. Patient-specific risk factors of PPOU are well described but little is known about factors that can be controlled by clinicians.

Objectives: To find PPOU risk factors among perioperative processes and pain-related patient-reported outcomes (PROs) on the first postoperative day.

Multidimensional pain assessment and opioid use after total knee arthroplasty: continuous vs single-injection regional vs systemic analgesia.

Introduction: Effective pain management after total knee arthroplasty (TKA) is essential for recovery. Continuous peripheral nerve blocks (PNBc) are often believed to provide superior pain relief compared with single-injection peripheral nerve blocks (PNBs). However, multidimensional pain-related patient-reported outcomes (PROs) have not been extensively studied.

Early opioid administration and pain-related patient-reported outcomes on the first postoperative day: an analysis of data from 111,693 patients in 392 surgical wards in Germany.

The risk-benefit ratio of perioperative opioid analgesia is controversial. Few studies have analyzed the effectiveness of opioids in the early postoperative period. To analyze the effectiveness of early opioid administration in this period in a large number of surgeries in routine care, we compared pain-related outcomes between patients treated on wards with different rates of early opioid administration.

The Incidence and Risk Factors of Persis tent Opioid Use After Surgery—A Retrospective Secondary Data Analysis.

Background: The risk of persistent postoperative opioid use (PPOU) and its association with the type of surgery are still unclear in Germany.

Methods: We conducted a nationwide retrospective cohort study on the basis of claims data from BARMER, a statutory health insurance carrier in Germany. Opioid-naive adults who did not have cancer and who underwent inpatient surgery in 2018 were included in the study.

Operation-specific risk of postoperative nausea: a cross-sectional study comparing 72 procedures.

Objectives: Determination of the procedure-specific, risk-adjusted probability of nausea.

Design: Cross-sectional analysis of clinical and patient-reported outcome data. We used a logistic regression model with type of operation, age, sex, preoperative opioids, antiemetic prophylaxis, regional anaesthesia, and perioperative opioids as predictors of postoperative nausea.

Responsiveness of multiple patient-reported outcome measures for acute postsurgical pain: primary results from the international multi-centre PROMPT NIT-1 study.

Background: Postsurgical outcome measures are crucial to define the efficacy of perioperative pain management; however, it is unclear which are most appropriate. We conducted a prospective study aiming to assess sensitivity-to-change of patient-reported outcome measures assessing the core outcome set of domains pain intensity (at rest/during activity), physical function, adverse events, and self-efficacy.

Methods: Patient-reported outcome measures were assessed preoperatively, on day 1 (d1), d3, and d7 after four surgical procedures (total knee replacement, breast surgery, endometriosis-related surgery, and sternotomy).

Risk Factors for Severe Pain and Impairment of Daily Life Activities after Cesarean Section-A Prospective Multi-Center Study of 11,932 Patients.

Cesarean section (CS) is the most widely performed and one of the most painful surgeries. This study investigated postoperative pain after CS using patient-related outcomes (PROs) to identify risk factors for severe pain. The secondary outcome was to evaluate the influence of surgery indication (primary CS (PCS) vs.

Fever and hypothermia represent two populations of sepsis patients and are associated with outside temperature.

Background: Fever and hypothermia have been observed in septic patients. Their influence on prognosis is subject to ongoing debates.

Methods: We did a secondary analysis of a large clinical dataset from a quality improvement trial.

Association of Perioperative Regional Analgesia with Postoperative Patient-Reported Pain Outcomes and Opioid Requirements: Comparing 22 Different Surgical Groups in 23,911 Patients from the QUIPS Registry.

(1) Background: In many surgical procedures, regional analgesia (RA) techniques are associated with improved postoperative analgesia compared to systemic pain treatment. As continuous RA requires time and experienced staff, it would be helpful to identify settings in which continuous RA has the largest benefit. (2) Methods: On the basis of 23,911 data sets from 179 German and Austrian hospitals, we analyzed the association of perioperative RA with patient-reported pain intensity, functional impairment of movement, nausea and opioid use for different surgeries.

Chronic Breast Pain Prior to Breast Cancer Surgery Is Associated with Worse Acute Postoperative Pain Outcomes.

Acute postoperative pain is associated with adverse short and long-term outcomes among women undergoing surgery for breast cancer. Previous studies identified preexisting pain as a predictor of postoperative pain, but rarely accounted for pain location or chronicity. This study leveraged a multinational pain registry, PAIN OUT, to: (1) characterize patient subgroups based on preexisting chronic breast pain status and (2) determine the association of preexisting chronic pain with acute postoperative pain-related patient-reported outcomes and opioid consumption following breast cancer surgery.

'Desire for more analgesic treatment': pain and patient-reported outcome after paediatric tonsillectomy and appendectomy.

Background: Insufficiently treated pain after paediatric appendectomy and tonsillectomy is frequent. We aimed to identify variables associated with poor patient-reported outcomes.

Methods: This analysis derives from the European PAIN OUT infant registry providing information on perioperative pharmacological data and patient-reported outcomes 24 h after surgery.

Towards Better Perioperative Pain Management in Mexico: A Study in a Network of Hospitals Using Quality Improvement Methods from PAIN OUT.

Objective: This was a pre-post study in a network of hospitals in Mexico-City, Mexico. Participants developed and implemented Quality Improvement (QI) interventions addressing perioperative pain management.

Methods: PAIN OUT, an international QI and research network, provided tools for web-based auditing and feedback of pain management and patient-reported outcomes (PROs) in the clinical routine.

Desire to Receive More Pain Treatment - A Relevant Patient-Reported Outcome Measure to Assess Quality of Post-Operative Pain Management? Results From 79,996 Patients Enrolled in the Pain Registry QUIPS from 2016 to 2019.

Acute postoperative pain is frequently evaluated by pain intensity scores. However, interpretation of the results is difficult and thresholds requiring treatment are not well defined. Additional patient-reported outcome measures (PROMs) might be helpful to better understand individual pain experience and quality of pain management after surgery.

[Quality improvement in conservative pain management (QUIKS) : A module of the QUIPS project for benchmarking of pain treatment in patients with nonoperative care].

Background: National and international surveys have shown that the quality of pain therapy in hospitals shows deficits, especially in the nonoperative disciplines.

Objective: The objective was to develop and clinically validate a module for the outcome and process parameters for pain management in patients in the context of a conservative/nonoperative hospital treatment analogous to the QUIPS questionnaire (quality improvement in postoperative pain therapy), which focuses on postoperative pain management.

Material And Methods: In a 4-step procedure the QUIPS outcome questionnaire and the process assessment sheet of the QUIPS module were adapted to the conditions of conservative/nonoperative treatment.

[Postoperative pain therapy after total knee arthroplasty : Is the local infiltration anesthesia the best therapy?].

Background: Optimal perioperative pain management after total knee arthroplasty is necessary to promote mobilization and achieve early rehabilitation. The aim of this study was to determine whether local infiltration anesthesia (LIA) is the better postoperative pain therapy compared to a femoral nerve block (FNB) or a sciatic nerve block (SNB) using routine data.

Methods: Data from the acute pain registry "Qualitätsverbesserung in der postoperativen Schmerztherapie" (QUIPS) were analyzed.

Non-Pharmacological Methods and Post-Operative Pain Relief: An Observational Study.

Background: Non-pharmacological methods (NPMs) like cold packs, acupuncture, meditation or distractions are supposed to ease acute post-surgical pain.

Objectives: This study assessed how frequently these methods are used in clinical routine and if their use is associated with pain relief or with the wish for more pain treatment.

Methods: Data from the world's largest acute post-operative pain registry, PAIN OUT, was used for this study.

The Quality of Postoperative Pain Therapy in German Hospitals.

Background: Many patients in German hospitals complain of inadequate treatment of their postoperative pain. Hospital-related structural and procedural variables may affect pain perception and patient satisfaction. We studied the association of individual variables with outcome quality.

Inter-Hospital Variability of Postoperative Pain after Tonsillectomy: Prospective Registry-Based Multicentre Cohort Study.

Objectives: Although tonsillectomy is one of the most frequent and painful surgeries, the association between baseline and process parameters and postoperative pain are not fully understood.

Methods: A multicentre prospective cohort study using a web-based registry enrolled 1,527 women and 1,008 men aged 4 to 85 years from 52 German hospitals between 2006 and 2015. Maximal pain (MP) score the first day after surgery on a numeric rating scale (NRS) from 0 (no pain) to 10 (MP) was the main outcome parameter.

Chronic postsurgical pain in Europe: An observational study.

Background: Chronic postsurgical pain (CPSP) is an important clinical problem. Prospective studies of the incidence, characteristics and risk factors of CPSP are needed.

Objectives: The objective of this study is to evaluate the incidence and risk factors of CPSP.

PAIN OUT: an international acute pain registry supporting clinicians in decision making and in quality improvement activities.

Rationale, Aims And Objectives: Management of post-operative pain is unsatisfactory worldwide. An estimated 240 million patients undergo surgery each year. Forty to 60% of these patients report clinically significant pain.