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Preventive Analgesia Is Associated with Reduced Pain Disability 3 Weeks but Not 6 Months after Major Gynecologic Surgery by Laparotomy

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dc.contributor.author Katz, Joel
dc.contributor.author Cohen, Lorenzo
dc.date.accessioned 2011-05-18T20:28:05Z
dc.date.available 2011-05-18T20:28:05Z
dc.date.issued 2004
dc.identifier.citation Anesthesiology, 101(1), 169-174. (2004) en
dc.identifier.uri http://hdl.handle.net/10315/7966
dc.description.abstract Background: Most studies of preemptive or preventive analgesia restrict outcomes to pain and analgesic consumption in the acute postoperative period. The potential longer-term effects on these and other domains of functioning have received little empirical attention. The purpose of this study was to follow up patients who had received general anesthesia plus epidural fentanyl and lidocaine before (group 1) or after (group 2) incision or general anesthesia plus a sham epidural (group 3). Methods: Patients were contacted approximately 3 weeks and 6 months after surgery. A follow-up pain questionnaire and the McGill Pain Questionnaire were administered by telephone. The Mental Health Inventory and Pain Disability Index were mailed to patients, completed, and mailed back. Results: One hundred thirty-one of the 141 patients (93%) were reached 3 weeks after surgery (n = 41, n = 48, and n = 42 in groups 1, 2, and 3, respectively), and 109 (77%) were reached at 6 months (n = 35, n = 37, and n = 37 in groups 1, 2, and 3, respectively). Multivariate analysis of covariance indicated that that even after controlling for age and presence or absence of preoperative pain, Pain Disability Index scores (mean ± SD) at the first follow-up were significantly lower in group 1 (17.3 ± 12.8) and group 2 (18.1 ± 17.0) compared with group 3 (26.3 ± 18.3). McGill Pain Questionnaire and Mental Health Inventory scores did not differ significantly among the groups. There were no significant differences at the 6-month follow-up. Conclusion: The short-term beneficial effects of preventive epidural analgesia translated into less pain disability 3 weeks after surgery. Progress in understanding the processes involved in postsurgical recovery and the risk factors for chronic postsurgical pain would be aided by baseline and postsurgical measures of relevant psychological, emotional, and physical variables. en
dc.language.iso en en
dc.publisher Lippincott, Williams and Wilkins en
dc.title Preventive Analgesia Is Associated with Reduced Pain Disability 3 Weeks but Not 6 Months after Major Gynecologic Surgery by Laparotomy en
dc.type Article en
dc.rights.journal http://journals.lww.com/anesthesiology/pages/default.aspx en
dc.rights.publisher http://www.lww.com/ en
dc.rights.article http://pdfs.journals.lww.com/anesthesiology/2004/07000/Preventive_Analgesia_Is_Associated_with_Reduced.26.pdf?token=method|ExpireAbsolute;source|Journals;ttl|1305750951231;payload|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;hash|YbUCMlnttmQ1bE0XGOh9qg== en

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