The development of screening test for the chronic postoperative pain

2021 Fiscal Year Final Research Report

• Project/Area Number: 18K08826
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55050:Anesthesiology-related
• Research Institution: Meikai University
• Principal Investigator: Yuka Oono 明海大学, 歯学部, 准教授 (70451961)
• Co-Investigator(Kenkyū-buntansha): 小長谷 光 明海大学, 歯学部, 教授 (20251548) ; 大上 沙央理 明海大学, 歯学部, 講師 (80451962)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Keywords: 遷延性術後痛

Outline of Final Research Achievements

Aim: To investigate the relationship between pre-operative conditioned pain modulation (CPM) and pain catastrophizing scale (PCS) and acute post-operative pain (POP) severity after orthognathic surgery by assessing pre-operative CPM and PCS. Methods: The pressure pain threshold and tonic painful cold-heat pulse stimulation were used as the test and conditioning stimuli, respectively. The pain area under the post-operative VAS area under the curve (VASAUC) was estimated. The associations between CPM, PCS, and VASAUC were also analyzed. Results: For patients with negative CPM effects, multiple regression analysis revealed a prediction formula of log(VASAUC) = (－0.02 × CPM effect) + (0.13 × PCS-Magnification) + 5.10 (adjusted R2 = 0.4578, p=0.00002, CPM effect; p=0.002, PCS-Magnification; p=0.0004), indicating that a weaker CPM and higher PCS scores were associated with more acute POP after surgery. Conclusion: CPM and PCS can predict acute POP following orthognathic surgery.

Free Research Field

歯科麻酔学分野

Academic Significance and Societal Importance of the Research Achievements

術前に評価した、内因性疼痛調節機構を反映すると考えられるConditioned Pain Modulation（CPM）と痛みの破局的思考Pain Catastrophizing Scale（PCS）が、術後痛を予測することが示唆された。術後急性痛は遷延性術後痛発症のリスクファクターであることが報告されており、本研究成果から術後急性痛発症のリスクが高い患者を同定することは、遷延性術後痛発症のスクリーニングにつながり、遷延性術後痛発症予防、ひいては治療に難渋する慢性疼痛発症予防に繋がると考えられる。結果として、国民のQOL上昇、医療費抑制等、大きな医療的、社会的及び経済的波及効果が見込まれる。