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Liu QR, Dai YC, Ji MH, Liu PM, Dong YY, Yang JJ. Risk Factors for Acute Postsurgical Pain: A Narrative Review. J Pain Res 2024; 17:1793-1804. [PMID: 38799277 PMCID: PMC11122256 DOI: 10.2147/jpr.s462112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/10/2024] [Indexed: 05/29/2024] Open
Abstract
Acute postsurgical pain (APSP) has received growing attention as a surgical outcome. When poorly controlled, APSP can affect short- and long-term outcomes in patients. Despite the steady increase in awareness about postoperative pain and standardization of pain prevention and treatment strategies, moderate-to-severe APSP is frequently reported in clinical practice. This is possibly because pain varies widely among individuals and is influenced by distinct factors, such as demographic, perioperative, psychological, and genetic factors. This review investigates the risk factors for APSP, including gender, age, obesity, smoking history, preoperative pain history, pain sensitivity, preoperative anxiety, depression, pain catastrophizing, expected postoperative pain, surgical fear, and genetic polymorphisms. By identifying patients having an increased risk of moderate-to-severe APSP at an early stage, clinicians can more effectively manage individualized analgesic treatment protocols with a combination of pharmacological and non-pharmacological interventions. This would alleviate the transition from APSP to chronic pain and reduce the severity of APSP-induced chronic physical disability and social psychological distress.
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Affiliation(s)
- Qing-Ren Liu
- Department of Anesthesiology, Xishan People’s Hospital of Wuxi City, Wuxi, 214105, People’s Republic of China
| | - Yu-Chen Dai
- Department of Anesthesiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, 210009, People’s Republic of China
| | - Mu-Huo Ji
- Department of Anesthesiology, The Second Affiliated Hospital, Nanjing Medical University, Nanjing, 210011, People’s Republic of China
| | - Pan-Miao Liu
- Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, People’s Republic of China
| | - Yong-Yan Dong
- Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, People’s Republic of China
| | - Jian-Jun Yang
- Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, People’s Republic of China
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Inauen DS, Papadopoulou AK, Eliades T, Papageorgiou SN. Pain profile during orthodontic levelling and alignment with fixed appliances reported in randomized trials: a systematic review with meta-analyses. Clin Oral Investig 2023; 27:1851-1868. [PMID: 36879148 PMCID: PMC10159949 DOI: 10.1007/s00784-023-04931-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/22/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE To assess the pain profile of patients in the levelling/alignment phase of orthodontic treatment, as reported from randomized clinical trials. MATERIALS AND METHODS Five databases were searched in September 2022 for randomized clinical trials assessing pain during levelling/alignment with a visual analogue scale (VAS). After duplicate study selection, data extraction, and risk-of-bias assessment, random effects meta-analyses of mean differences (MDs) and their 95% confidence intervals (CIs) were performed, followed by subgroup/meta-regression, and certainty analyses. RESULTS A total of 37 randomized trials including 2277 patients (40.3% male; mean age 17.5 years) were identified. Data indicated quick pain initiation after insertion of orthodontic appliances (n = 6; average = 12.4 mm VAS), a quick increase to a peak at day 1 (n = 29; average = 42.4 mm), and gradually daily decrease the first week until its end (n = 23; average = 9.0 mm). Every second patient reported analgesic use at least once this week (n = 8; 54.5%), with peak analgesic use at 6 h post-insertion (n = 2; 62.3%). Patients reported reduced pain in the evening compared to morning (n = 3; MD = - 3.0 mm; 95%CI = - 5.3, - 0.6; P = 0.01) and increased pain during chewing (n = 2; MD = 19.2 mm; 95% CI = 7.9, 30.4; P < 0.001) or occlusion of the back teeth (n = 2; MD = 12.4 mm; 95% CI = 1.4, 23.4; P = 0.3), while non-consistent effects were seen for patient age, sex, irregularity, or analgesic use. Subgroup analyses indicated increased pain among extraction cases and during treatment of the lower (rather than the upper) arch, while certainty around estimates was moderate to high. CONCLUSIONS Evidence indicated a specific pain profile during orthodontic levelling/alignment, without signs of consistent patient-related influencing factors.
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Affiliation(s)
- Deborah Susanne Inauen
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstr. 11, 8032, Zurich, Switzerland
| | - Alexandra K Papadopoulou
- Division of Orthodontics, Faculty of Medicine, University Clinics of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1206, Geneva, Switzerland
- Discipline of Orthodontics and Paediatric Dentistry, Sydney Dental School, The University of Sydney, Sydney, Australia
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstr. 11, 8032, Zurich, Switzerland
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstr. 11, 8032, Zurich, Switzerland.
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Soares Bonato RC, Abel Mapengo MA, de Azevedo-Silva LJ, Janson G, de Carvalho Sales-Peres SH. Tooth movement, orofacial pain, and leptin, interleukin-1β, and tumor necrosis factor-α levels in obese adolescents. Angle Orthod 2022; 92:95-100. [PMID: 34338736 PMCID: PMC8691476 DOI: 10.2319/011321-44.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 05/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate tooth movement, orofacial pain, and leptin, interleukin (IL)-1β, and tumor necrosis factor (TNF)-α cytokine levels in the gingival crevicular fluid (GCF) during orthodontic treatment in obese adolescents. MATERIALS AND METHODS Participants included adolescent patients aged 12-18 years: group 1, obese (n = 30), and group 2, nonobese controls (n = 30). They were evaluated before (T0) and after 1 hour (T1), 24 hours (T2), and 1 week (T3) of fixed appliance bonding. Periodontal examination (T0), collection of GCF (T1, T2, T3), and evaluation of Little's irregularity index (T0, T3) were performed, and a visual analog scale was used to measure pain (T1, T2, T3). Evaluation of IL-1β, TNF-α, and leptin cytokines was performed using a Luminex assay. Mann-Whitney and t-tests were used for intergroup comparisons, and a generalized estimating equation and cluster analyses were used for comparisons among observation times (P < .05). RESULTS The obese group had a higher prevalence of probing depth of ≥4 mm and bleeding on probing. Orthodontic tooth movement was similar in both groups. Peak of pain was at T2 in both groups and was higher in the obese patients. TNF-α showed a slight increase at T1, followed by a gradual decrease at T2 and T3 in both groups. The obese group had a higher concentration of IL-1β before and during orthodontic treatment. There was no difference in tooth movement between obese and control patients during the first week of orthodontic treatment. CONCLUSIONS Obese adolescents had a greater subjective report of orofacial pain after 24 hours of orthodontic treatment and higher concentrations of IL-1β proinflammatory cytokine before and during tooth movement as compared with nonobese control adolescents.
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Verdú E, Homs J, Boadas-Vaello P. Physiological Changes and Pathological Pain Associated with Sedentary Lifestyle-Induced Body Systems Fat Accumulation and Their Modulation by Physical Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413333. [PMID: 34948944 PMCID: PMC8705491 DOI: 10.3390/ijerph182413333] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/02/2021] [Accepted: 12/10/2021] [Indexed: 12/11/2022]
Abstract
A sedentary lifestyle is associated with overweight/obesity, which involves excessive fat body accumulation, triggering structural and functional changes in tissues, organs, and body systems. Research shows that this fat accumulation is responsible for several comorbidities, including cardiovascular, gastrointestinal, and metabolic dysfunctions, as well as pathological pain behaviors. These health concerns are related to the crosstalk between adipose tissue and body systems, leading to pathophysiological changes to the latter. To deal with these health issues, it has been suggested that physical exercise may reverse part of these obesity-related pathologies by modulating the cross talk between the adipose tissue and body systems. In this context, this review was carried out to provide knowledge about (i) the structural and functional changes in tissues, organs, and body systems from accumulation of fat in obesity, emphasizing the crosstalk between fat and body tissues; (ii) the crosstalk between fat and body tissues triggering pain; and (iii) the effects of physical exercise on body tissues and organs in obese and non-obese subjects, and their impact on pathological pain. This information may help one to better understand this crosstalk and the factors involved, and it could be useful in designing more specific training interventions (according to the nature of the comorbidity).
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Affiliation(s)
- Enrique Verdú
- Research Group of Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, 17003 Girona, Spain;
- Correspondence: (E.V.); (P.B.-V.)
| | - Judit Homs
- Research Group of Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, 17003 Girona, Spain;
- Department of Physical Therapy, EUSES-University of Girona, 17190 Salt, Spain
| | - Pere Boadas-Vaello
- Research Group of Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, 17003 Girona, Spain;
- Correspondence: (E.V.); (P.B.-V.)
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Saloom HF, Boustan R, Seehra J, Papageorgiou SN, Carpenter GH, Cobourne MT. The impact of obesity on orthodontic treatment outcome in adolescents: a prospective clinical cohort study. Eur J Orthod 2021; 43:165-172. [PMID: 32390057 DOI: 10.1093/ejo/cjaa032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION This prospective clinical cohort study investigated the potential influence of obesity on orthodontic treatment outcome. METHODS A prospective cohort of adolescent patients undergoing routine fixed appliance treatment were recruited into normal-weight or obese groups based upon body mass index (BMI) centile and followed up until the completion of treatment. Primary outcome was treatment duration, and secondary outcomes included treatment outcome (occlusal change measured using peer assessment rating [PAR]), appointment characteristics, and compliance measures. RESULTS A total of 45 patients mean age 14.8 (1.6) years were included in the final analysis. The normal-weight group included 23 patients with mean BMI 19.4 (2.4) kg/m2 and the obese group 22 patients with mean BMI 30.5 (3.8) kg/m2. There were no significant differences in baseline demographics between groups, except for BMI and pre-treatment PAR. The normal-weight group had a mean pre-treatment PAR of 25.6 (8.3) and the obese 33.3 (11.8) giving the obese group a more severe pre-treatment malocclusion (P = 0.02). There were no significant differences in treatment duration between groups (P = 0.36), but obese patients needed less time per each additional baseline PAR point compared to normal weight (P = 0.02). Obese patients also needed less appointments compared to normal-weight patients (P = 0.02). There were no significant differences between groups for appointment characteristics or compliance. Finally, obese patients were more likely to experience a great PAR reduction than normal-weight patients (relative risk = 2.6; 95% confidence interval = 1.2-4.2; P = 0.02). CONCLUSIONS There were no significant differences in treatment duration between obese and normal-weight patients. Obesity does not appear to be a risk factor for negative orthodontic treatment outcome with fixed appliances.
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Affiliation(s)
- Hayder F Saloom
- Centre for Craniofacial Development and Regeneration, Department of Orthodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK.,Centre for Host-Microbiome Interactions, Department of Mucosal and Salivary Biology, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK.,Orthodontic Department, College of Dentistry, University of Baghdad, Iraq
| | - Roshanak Boustan
- Centre for Craniofacial Development and Regeneration, Department of Orthodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK
| | - Jadbinder Seehra
- Centre for Craniofacial Development and Regeneration, Department of Orthodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Guy H Carpenter
- Centre for Host-Microbiome Interactions, Department of Mucosal and Salivary Biology, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK
| | - Martyn T Cobourne
- Centre for Craniofacial Development and Regeneration, Department of Orthodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK
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Michelogiannakis D, Rossouw PE, Khan J, Akram Z, Menenakos E, Javed F. Influence of increased body mass index on orthodontic tooth movement and related parameters in children and adolescents: A systematic review of longitudinal controlled clinical studies. J Orthod 2019; 46:323-334. [DOI: 10.1177/1465312519873669] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objectives: To assess the impact of increased body mass index (BMI) on orthodontic tooth movement (OTM) and related parameters in children and adolescents. Search sources: A search of six electronic databases and manual searching were performed up to June 2019 without language and time restrictions. Data selection: Eligibility criteria were as follows: (1) longitudinal controlled clinical studies; (2) children and adolescents undergoing orthodontic therapy (OT); (3) no systemic diseases; (4) experimental group: patients with increased BMI; and (5) control group: patients with normal BMI. Data extraction: Screening, study selection and data extraction were performed; bias within studies was assessed using the Risk of Bias In Non-randomised Studies (ROBINS-I) tool. Results: Seven studies were included. One study showed that an increased BMI is associated with less wear-time of removable orthodontic appliances and one study found no significant association. One study showed that an increased BMI is associated with less cooperation during OT; however, not with the treatment results. One study reported higher pain experience during OT in adolescents with than without increased BMI. Two studies showed that increased BMI in adolescents is related to OTM, one with increased and one with decreased rates of OTM, respectively. One study reported an association between increased BMI and incidence of white spot lesions and gingivitis during OT. The ROBINS-I tool showed low to moderate risk of bias within studies. Conclusions: The influence of BMI on OTM and related parameters in children and adolescents remains debatable.
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Affiliation(s)
- Dimitrios Michelogiannakis
- Division of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, NY, USA
| | - P Emile Rossouw
- Division of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, NY, USA
| | - Junad Khan
- Clinic of Orofacial Pain and Temporomandibular Joint Disorders, Eastman Institute for Oral Health, University of Rochester, NY, USA
| | - Zohaib Akram
- UWA Dental School, The University of Western Australia, Perth 6009, WA, Australia
| | - Evangelos Menenakos
- 1st Propaedeutic Surgical Department, “Evgenidion” Hospital of Athens, Medical School of Athens, National and Kapodistrian University of Athens, Greece
| | - Fawad Javed
- Division of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, NY, USA
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7
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Majchrzak M, Brzecka A, Daroszewski C, Błasiak P, Rzechonek A, Tarasov VV, Chubarev VN, Kurinnaya AS, Melnikova TI, Makhmutova A, Klochkov SG, Somasundaram SG, Kirkland CE, Aliev G. Increased Pain Sensitivity in Obese Patients After Lung Cancer Surgery. Front Pharmacol 2019; 10:626. [PMID: 31258474 PMCID: PMC6586739 DOI: 10.3389/fphar.2019.00626] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 05/15/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Obesity and cancer are recognized worldwide health threats. While there is no reported causal relationship, the increasing frequency of both conditions results in a higher incidence of obese patients who are being treated for cancer. Physiological data indicate that there is a relationship between obesity and susceptibility to pain; however, currently, there are no specific pharmacological interventions. Objective: To evaluate the self-reported intensity of postoperative pain in obese and nonobese lung cancer who receive either thoracotomy or video-assisted thoracic surgery (VATS) surgical therapy. Material and Methods: In 50 obese [mean body mass index (BMI) of 34.1 ± 3.2 kg/m2] and 62 nonobese (mean BMI of 24.9 ± 3 kg/m2) lung cancer patients, the intensity of pain was estimated every 4 h using a visual analog scale (VAS, 0 indicating no pain and 10 indicating “worst imaginable pain”) beginning shortly after surgery (Day O) and continuing until the day of discharge (Day D). Results: The self-reported pain was more severe in obese than in nonobese patients, both at the time of the operation [Day O (4.5 ± 1.2 vs 3.4 ± 1.1; p < 0.0001)] and at the day of discharge [Day D (3.9 ± 1.4 vs 2.6 ± 0.9, p < 0.0001)]. This finding was consistent both in the patients after thoracotomy and after video-assisted thoracic surgery (VATS, p < 0.0001). The patients with severe pain shortly after surgery (VAS score >4) had significantly higher BMI (31.8 ± 5.6 kg/m2vs 28.8 ± 5.2 kg/m2, p < 0.01) and were hospitalized longer than the remaining patients (13.0 ± 13.6 days vs 9.5 ± 3.6 days, p < 0.05). Conclusion: The reported perception of pain in obese lung cancer patients is greater than in nonobese patients undergoing the same thoracic surgery. In obese patients, severe pain persisted longer. Pain management is an important consideration in the postoperative care of lung cancer patients, even more so with obese patients.
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Affiliation(s)
- Maciej Majchrzak
- Department of Thoracic Surgery, Medical University in Wroclaw, Wroclaw, Poland
| | - Anna Brzecka
- Department of Pulmonology and Lung Cancer, Medical University in Wroclaw, Wroclaw, Poland
| | - Cyryl Daroszewski
- Department of Pulmonology and Lung Cancer, Medical University in Wroclaw, Wroclaw, Poland
| | - Piotr Błasiak
- Department of Thoracic Surgery, Medical University in Wroclaw, Wroclaw, Poland
| | - Adam Rzechonek
- Department of Thoracic Surgery, Medical University in Wroclaw, Wroclaw, Poland
| | - Vadim V Tarasov
- Department of Pharmacology and Pharmacy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Vladimir N Chubarev
- Department of Pharmacology and Pharmacy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anastasiya S Kurinnaya
- Department of Pharmacology and Pharmacy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Tatiana I Melnikova
- Department of Pharmacology and Pharmacy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Alfiya Makhmutova
- Institute of Physiologically Active Compounds, Russian Academy of Sciences, Chernogolovka, Russia
| | - Sergey G Klochkov
- Institute of Physiologically Active Compounds, Russian Academy of Sciences, Chernogolovka, Russia
| | - Siva G Somasundaram
- Department of Biological Sciences, Salem University, Salem, WV, United States
| | - Cecil E Kirkland
- Department of Biological Sciences, Salem University, Salem, WV, United States
| | - Gjumrakch Aliev
- Department of Pharmacology and Pharmacy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Institute of Physiologically Active Compounds, Russian Academy of Sciences, Chernogolovka, Russia.,GALLY International Biomedical Research Institute, San Antonio, TX, United States
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