Bridging the pain gap after cancer surgery – Evaluating the feasibility of transitional pain service to prevent persistent postsurgical pain – A systematic review and meta-analysis
Background and Aims: The lack of a dedicated pain service catering to the postsurgical period has resulted in the origination of the pain–period gap. This has led to a resurgence of transitional pain service (TPS). Our objective was to evaluate the feasibility of TPS in pain practice among postsurgi...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-10-01
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| Series: | Indian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/ija.ija_405_24 |
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| author | Raghu S. Thota S Ramkiran Aveek Jayant Koilada Shiv Kumar Anjana Wajekar Sadasivan Iyer M Ashwini |
| author_facet | Raghu S. Thota S Ramkiran Aveek Jayant Koilada Shiv Kumar Anjana Wajekar Sadasivan Iyer M Ashwini |
| author_sort | Raghu S. Thota |
| collection | DOAJ |
| description | Background and Aims:
The lack of a dedicated pain service catering to the postsurgical period has resulted in the origination of the pain–period gap. This has led to a resurgence of transitional pain service (TPS). Our objective was to evaluate the feasibility of TPS in pain practice among postsurgical cancer patients and its prevention of persistent postsurgical pain (PPSP), culminating in chronic pain catastrophising.
Methods:
The protocol for this meta-analysis was registered in the International Prospective Register of Systematic Reviews (ID: CRD42023407190). This systematic review included articles involving all adult cancer patients undergoing cancer-related surgery experiencing pain, involving pharmacological, non-pharmacological and interventional pain modalities after an initial systematic pain assessment by pain care providers across diverse clinical specialities, targeting multimodal integrative pain management. Meta-analysis with meta-regression was conducted to analyse the feasibility of TPS with individual subgroup analysis and its relation to pain-related patient outcomes.
Results:
Three hundred seventy-four articles were evaluated, of which 14 manuscripts were included in the meta-analysis. The lack of randomised controlled trials evaluating the efficacy of TPS in preventing PPSP and pain catastrophising led to the analysis of its feasibility by meta-regression. The estimate among study variances τ2 was determined and carried out along with multivariate subgroup analysis. A regression coefficient was attained to establish the correlation between the feasibility of TPS and its patient outcome measures and opioid-sparing.
Conclusion:
TPS interventions carried out by multidisciplinary teams incorporating bio-physical-psychological pain interventions have resulted in its successful implementation with improved pain-related patient outcomes mitigating the occurrence of PPSP. |
| format | Article |
| id | doaj-art-79ebe53762a343b799a1b5d0cb70a17b |
| institution | Kabale University |
| issn | 0019-5049 0976-2817 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj-art-79ebe53762a343b799a1b5d0cb70a17b2025-01-24T15:05:51ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172024-10-01681086187410.4103/ija.ija_405_24Bridging the pain gap after cancer surgery – Evaluating the feasibility of transitional pain service to prevent persistent postsurgical pain – A systematic review and meta-analysisRaghu S. ThotaS RamkiranAveek JayantKoilada Shiv KumarAnjana WajekarSadasivan IyerM AshwiniBackground and Aims: The lack of a dedicated pain service catering to the postsurgical period has resulted in the origination of the pain–period gap. This has led to a resurgence of transitional pain service (TPS). Our objective was to evaluate the feasibility of TPS in pain practice among postsurgical cancer patients and its prevention of persistent postsurgical pain (PPSP), culminating in chronic pain catastrophising. Methods: The protocol for this meta-analysis was registered in the International Prospective Register of Systematic Reviews (ID: CRD42023407190). This systematic review included articles involving all adult cancer patients undergoing cancer-related surgery experiencing pain, involving pharmacological, non-pharmacological and interventional pain modalities after an initial systematic pain assessment by pain care providers across diverse clinical specialities, targeting multimodal integrative pain management. Meta-analysis with meta-regression was conducted to analyse the feasibility of TPS with individual subgroup analysis and its relation to pain-related patient outcomes. Results: Three hundred seventy-four articles were evaluated, of which 14 manuscripts were included in the meta-analysis. The lack of randomised controlled trials evaluating the efficacy of TPS in preventing PPSP and pain catastrophising led to the analysis of its feasibility by meta-regression. The estimate among study variances τ2 was determined and carried out along with multivariate subgroup analysis. A regression coefficient was attained to establish the correlation between the feasibility of TPS and its patient outcome measures and opioid-sparing. Conclusion: TPS interventions carried out by multidisciplinary teams incorporating bio-physical-psychological pain interventions have resulted in its successful implementation with improved pain-related patient outcomes mitigating the occurrence of PPSP.https://journals.lww.com/10.4103/ija.ija_405_24acute pain servicechronic postsurgical painopioid-sparingonco-anaesthesiapain catastrophisingpalliative carepersistent postsurgical paintransitional pain service |
| spellingShingle | Raghu S. Thota S Ramkiran Aveek Jayant Koilada Shiv Kumar Anjana Wajekar Sadasivan Iyer M Ashwini Bridging the pain gap after cancer surgery – Evaluating the feasibility of transitional pain service to prevent persistent postsurgical pain – A systematic review and meta-analysis Indian Journal of Anaesthesia acute pain service chronic postsurgical pain opioid-sparing onco-anaesthesia pain catastrophising palliative care persistent postsurgical pain transitional pain service |
| title | Bridging the pain gap after cancer surgery – Evaluating the feasibility of transitional pain service to prevent persistent postsurgical pain – A systematic review and meta-analysis |
| title_full | Bridging the pain gap after cancer surgery – Evaluating the feasibility of transitional pain service to prevent persistent postsurgical pain – A systematic review and meta-analysis |
| title_fullStr | Bridging the pain gap after cancer surgery – Evaluating the feasibility of transitional pain service to prevent persistent postsurgical pain – A systematic review and meta-analysis |
| title_full_unstemmed | Bridging the pain gap after cancer surgery – Evaluating the feasibility of transitional pain service to prevent persistent postsurgical pain – A systematic review and meta-analysis |
| title_short | Bridging the pain gap after cancer surgery – Evaluating the feasibility of transitional pain service to prevent persistent postsurgical pain – A systematic review and meta-analysis |
| title_sort | bridging the pain gap after cancer surgery evaluating the feasibility of transitional pain service to prevent persistent postsurgical pain a systematic review and meta analysis |
| topic | acute pain service chronic postsurgical pain opioid-sparing onco-anaesthesia pain catastrophising palliative care persistent postsurgical pain transitional pain service |
| url | https://journals.lww.com/10.4103/ija.ija_405_24 |
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