Abstract：
BACKGROUND: Despite advancements in surgical and anesthesia techniques, acute and persistent postoperative pain are still a common challenge. Postoperative pain has direct effects on individual patient care and outcome, as well as putting strain on limited health care resources. Several prediction methods for postoperative pain have been described. One such method is the assessment of pain during peripheral venous cannulation (VCP). It is not known if different approaches to anesthesia and analgesia, depending on the evaluation of risk for postoperative pain, can improve outcome. The aim of this study is to evaluate if individualized anesthesia and analgesia can affect postoperative pain and recovery after surgery, in patients stratified by VCP.
METHODS: Adult patients scheduled for laparoscopic surgery undergo pain-sensitivity stratification using VCP on the day of surgery. Patients scoring VCP ≥2.0 on the visual analogue scale (pain-sensitive) are randomized to multimodal anaesthesia and analgesia with opioids or standard of care. Patients scoring VCP ≤1.9 (pain-tolerant) are randomized to opioid-free anaesthesia or standard of care. The primary outcome is acute postoperative pain measured with numeric rating scale in the postoperative care unit. Secondary outcomes include analysis of pain after 24 h, persistent postoperative pain and quality of recovery.
CONCLUSIONS: Individualized perioperative pain management has the potential to improve patient care. This study will examine the impact of different anesthesia and analgesia regimes, in patients with differing pain sensitivity, on postoperative pain.
BACKGROUND: Prospectively posted at ClinicalTrials.gov, identifier NCT04751812.
METHODS: Adult patients scheduled for laparoscopic surgery undergo pain-sensitivity stratification using VCP on the day of surgery. Patients scoring VCP ≥2.0 on the visual analogue scale (pain-sensitive) are randomized to multimodal anaesthesia and analgesia with opioids or standard of care. Patients scoring VCP ≤1.9 (pain-tolerant) are randomized to opioid-free anaesthesia or standard of care. The primary outcome is acute postoperative pain measured with numeric rating scale in the postoperative care unit. Secondary outcomes include analysis of pain after 24 h, persistent postoperative pain and quality of recovery.
CONCLUSIONS: Individualized perioperative pain management has the potential to improve patient care. This study will examine the impact of different anesthesia and analgesia regimes, in patients with differing pain sensitivity, on postoperative pain.
BACKGROUND: Prospectively posted at ClinicalTrials.gov, identifier NCT04751812.
摘要：
背景：尽管在手术和麻醉技术方面取得了进步，急性和持续性术后疼痛仍然是一个共同的挑战。术后疼痛对个体患者的护理和预后有直接影响，以及给有限的医疗资源带来压力。已经描述了几种术后疼痛的预测方法。一种这样的方法是评估外周静脉插管(VCP)期间的疼痛。不知道是否有不同的麻醉和镇痛方法，根据对术后疼痛风险的评估，可以改善结果。这项研究的目的是评估个体化麻醉和镇痛是否会影响术后疼痛和术后恢复，在VCP分层的患者中。
方法：计划进行腹腔镜手术的成年患者在手术当天使用VCP进行疼痛敏感性分层。在视觉模拟评分（疼痛敏感）上VCP≥2.0的患者被随机分配到阿片类药物或标准护理的多模式麻醉和镇痛。评分为VCP≤1.9（耐痛）的患者被随机分配到无阿片类药物麻醉或标准护理。主要结果是在术后监护室用数字评分量表测量的急性术后疼痛。次要结果包括24小时后疼痛分析，持续的术后疼痛和恢复质量。
结论：个体化围手术期疼痛管理有可能改善患者护理。这项研究将检查不同的麻醉和镇痛方案的影响，在不同疼痛敏感性的患者中，术后疼痛。
背景：前瞻性地发布在ClinicalTrials.gov上，标识符NCT04751812。
方法：计划进行腹腔镜手术的成年患者在手术当天使用VCP进行疼痛敏感性分层。在视觉模拟评分（疼痛敏感）上VCP≥2.0的患者被随机分配到阿片类药物或标准护理的多模式麻醉和镇痛。评分为VCP≤1.9（耐痛）的患者被随机分配到无阿片类药物麻醉或标准护理。主要结果是在术后监护室用数字评分量表测量的急性术后疼痛。次要结果包括24小时后疼痛分析，持续的术后疼痛和恢复质量。
结论：个体化围手术期疼痛管理有可能改善患者护理。这项研究将检查不同的麻醉和镇痛方案的影响，在不同疼痛敏感性的患者中，术后疼痛。
背景：前瞻性地发布在ClinicalTrials.gov上，标识符NCT04751812。
