Systematic Review of Methods for Individual Prediction of Postoperative Pain.

Abstract

Background: Acute postoperative pain is a common problem in clinical practice and merits attention considering its potential long-term adverse effects. This systematic review covers current knowledge on methods for individual prediction of postoperative pain. Methods: A systematic literature search was conducted using the PubMed, EMBASE, and CINAHL databases for original studies with adult patients published in English between 2016 and 2022. Inclusion required assessment of risk factors preoperatively and assessment of postoperative pain. No reviews, meta-analyses, or study protocols were included, nor studies with outcomes other than pain or where risk factor analysis was not performed preoperatively. A two peer-reviewed system was utilized using the screening and data collection tool Covidence, with a focus on new tools for preoperative pain prediction. The results were only analyzed qualitatively. Results: The search yielded 1950 abstracts to be screened. In total, 208 articles were subjected to full-text review, and 107 articles were included in the data synthesis of this review. The evaluated scientific methods were grouped and analyzed separately. Psychometric questionnaires and methods for quantitative sensory testing are still being studied. New methods proposed include the evaluation of pain induced by tourniquet inflation, venous cannulation, or pin-prick stimulation, the analgesia/nociception index, electroencephalographic recording, and other new equipment developed for this purpose. Conclusion: Various screening methods have been proposed to identify patients prone to postoperative pain. The focus has shifted from procedure-specific to individualized strategies to improve early management of pain. However, many traditional predictive methods still have a questionable role in clinical practice. Trial Registration: ClinicalTrials.gov identifier: CRD42022298479.