Does Optimal Control of Pre-operative Chronic and Acute Pain Predict Improved Function After Orthopedic Surgery?
Status:
Completed
Trial end date:
2010-06-01
Target enrollment:
Participant gender:
Summary
Despite the development of new pain medications, the prevalence of persistent postoperative
pain (for more than three to six months) remains alarmingly high. Chronic pain and reduced
function after surgery are of great concern since they have a significant impact on a
patient's quality of life and are costly to society in terms of longer hospital stays and
lost work days. An important risk factor for chronic pain and reduced function after surgery
is the amount of pain patients experience immediately after surgery which is highly
influenced by the amount of pain patients have preoperatively. For many patients,
longstanding pain prior to surgery is common and thus can compromise the outcome of the
procedure. Therefore, the aim of this study is to reduce the amount of pain patients have
before they undergo surgery by administering a novel pain-relieving regimen in the weeks
before surgery. Crucially, this treatment will be continued for three weeks after surgery to
reduce pain that arises from the surgical trauma. The novel regimen will include a
non-steroidal anti-inflammatory (celecoxib) and the alpha2 delta ligand, pregabalin. This
drug combination will provide the best opportunity to target several key sites in the pain
pathway. This regimen will be tested in patients with pain related to osteoarthritis and who
are undergoing orthopedic (hip) surgery because chronic preoperative pain is common in these
patients and is the main reason for undergoing surgery. The goal of this research proposal is
to adequately manage pain before and after surgery in order to improve function weeks after
surgery. If controlling pain in this way does lead to improved long term postoperative
function the findings from this study may lead to the development of a standardized regimen.
This is highly relevant not only for orthopedic procedures but following other common
surgical procedures which would be of great benefit to patients and the entire healthcare
system.