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The effect of implementation of pain neuroscience education and rehabilitation exercise on post-operative pain and recovery after laparoscopic colorectal surgery: a prospective randomized controlled trial

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Abstract

Purposes

To optimize the efficacy of analgesia and post-operative recovery for patients undergoing laparoscopic colorectal surgery by integrating a composite psycho-somatic analgesia algorithm involving peri-operative rehabilitation exercise and pain neuroscience education into multi-modal analgesia.

Methods

A prospective randomized controlled trial was conducted to compare conventional peri-operative analgesia (group CA) and the addition of rehabilitation exercise and pain neuroscience education into it (group REPNE) for patients undergoing laparoscopic colorectal surgery. Acute and chronic post-operative pain, characteristics of pain (pain catastrophizing, sensitization, and trends of neuropathic transformation), and quality of post-operative recovery calibrated with EuroQol Five Dimensions Questionnaire (EQ-5D-5L) were investigated and compared between two groups.

Results

A total of 175 patients consented to participate in this study. Compared with those receiving conventional analgesia (group CA, N = 89), patients in group REPNE (N = 86) reported reduced intensity of pain 24 h after surgery, less risk of pain catastrophizing and sensitization, and better quality of life during hospitalization recovery till 1 month after surgery (p < 0.05). No statistical difference was found for neuropathic transformation of post-operative pain or for the incidence of chronic post-operative pain (p > 0.05).

Conclusions

The addition of peri-operative rehabilitation exercise and pain neuroscience education into multi-modal analgesia provided better analgesic effect compared with routine practice for patients receiving laparoscopic colorectal surgery and also facilitated better post-operative recovery. This composite psycho-somatic algorithm for peri-operative analgesia merits further application in clinical practice.

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Data availability

The dataset analyzed in the current study is available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank the staff of the Departments of Colorectal Surgery, Nutrition, Rehabilitation in the First Affiliated Hospital of Chongqing Medical University for their support, work, and friendship. The authors also thank the statistical guidance and assistance from the School of Public Health and Management, Chongqing Medical University. We thank the participants of the study.

Funding

This project was funded by the Technology Promotion Project of Chongqing Health Administration (2020jstg026), National Key Clinical Specialty Construction Project (No. 2011-170), Chongqing Medical Key Discipline Construction Project (No. 2007-2), and Chongqing Kewei Joint Technology Innovation and Application Development Project (2020MSXM042).

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Author notes

  1. Lihua Peng and Yun Song contributed equally as first authors.

Authors and Affiliations

  1. The Department of Anesthesia and Pain Medicine, The First Affiliated Hospital of Chongqing Medical University, #1 Road Youyi Road, Yuanjiagang Community, Yuzhong District, Chongqing, 400016, China

    Lihua Peng & Chen Jing

  2. The Department of Anesthesiology, Chongqing Health Center for Women and Children, Women and Children Hospital of Chongqing Medical University, 120# Longshan Road, Yubei District, Chongqing, 401147, China

    Yun Song

  3. The Department of Anesthesia and Surgical Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Biqiong Lv

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  1. Lihua Peng
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  4. Chen Jing
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Contributions

LP and YS designed the study. YS, SM, and BL carried out the trial intervention. JC collected the data. LP and YS analyzed the results. LP and YS drafted the article. All authors reviewed the final article and approved it for submission.

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Correspondence to Lihua Peng or Yun Song.

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Peng, L., Song, Y., Lv, B. et al. The effect of implementation of pain neuroscience education and rehabilitation exercise on post-operative pain and recovery after laparoscopic colorectal surgery: a prospective randomized controlled trial. J Anesth 37, 775–786 (2023). https://doi.org/10.1007/s00540-023-03235-y

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