Cognitive flexibility and persistent post-surgical pain: the FLEXCAPP prospective observational study.

Autor:	Vila MR; Department of Anesthesiology, Washington University School of Medicine in St Louis, St Louis, MO, USA., Todorovic MS; Department of Anesthesiology, Washington University School of Medicine in St Louis, St Louis, MO, USA., Tang C; Department of Anesthesiology, Washington University School of Medicine in St Louis, St Louis, MO, USA., Fisher M; Department of Anesthesiology, Washington University School of Medicine in St Louis, St Louis, MO, USA., Steinberg A; Department of Anesthesiology, Washington University School of Medicine in St Louis, St Louis, MO, USA., Field B; Department of Anesthesiology, Washington University School of Medicine in St Louis, St Louis, MO, USA., Bottros MM; Department of Anesthesiology, Washington University School of Medicine in St Louis, St Louis, MO, USA; Washington University Pain Center, Washington University School of Medicine in St Louis, St Louis, MO, USA., Avidan MS; Department of Anesthesiology, Washington University School of Medicine in St Louis, St Louis, MO, USA., Haroutounian S; Department of Anesthesiology, Washington University School of Medicine in St Louis, St Louis, MO, USA; Washington University Pain Center, Washington University School of Medicine in St Louis, St Louis, MO, USA. Electronic address: simon.haroutounian@wustl.edu.
Jazyk:	angličtina
Zdroj:	British journal of anaesthesia [Br J Anaesth] 2020 May; Vol. 124 (5), pp. 614-622. Date of Electronic Publication: 2020 Mar 10.
DOI:	10.1016/j.bja.2020.02.002
Abstrakt:	Background: Impaired performance on tasks assessing executive function has been linked to chronic pain. We hypothesised that poor performance on tests assessing the ability to adjust thinking in response to changing environmental stimuli (cognitive flexibility) would be associated with persistent post-surgical pain. Methods: We conducted a single-centre prospective observational study in two perioperative cohorts: patients undergoing total knee arthroplasty or noncardiac chest surgical procedures. The co-primary outcome measures compared preoperative performance on the Trail Making Test and the colour-word matching Stroop test between patients who developed persistent post-surgical pain and those who did not. Secondary outcome measures included the associations between these test scores and pain severity at 6 months. Results: Of 300 participants enrolled, 198 provided 6 month follow-up data. There were no significant differences in preoperative Trail Making Test B minus A times (33 vs 34 s; P=0.59) or Stroop interference T-scores (47th vs 48th percentile; P=0.50) between patients with and without persistent post-surgical pain (primary outcome). Of those who reported persistent post-surgical pain, poorer baseline performance on the colour-word matching Stroop test was associated with higher pain scores at 6 months in both knee arthroplasty (r=-0.32; P=0.04) and chest (r=-0.44; P=0.02) surgeries (secondary outcome). Conclusions: Preoperative cognitive flexibility test performance was not predictive of overall persistent post-surgical pain incidence 6 months after surgery. However, poor performance on the colour-word matching Stroop test was independently associated with more severe persistent post-surgical pain in both cohorts. Clinical Trial Registration: NCT02579538. (Copyright © 2020 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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