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Prediction of postoperative pain after percutaneous nephrolithotomy: can preoperative experimental pain assessment identify patients at risk?

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Abstract

Postoperative pain remains a significant problem and the individual variance in postoperative pain is not fully understood. In recent years, there has been focus on identifying risk factors predicting patients with high postoperative pain intensity or consumption of analgesics, which may facilitate an improvement in rehabilitation. This study evaluates the relationship between preoperative experimental pain assessment and postoperative pain and opioid consumption. Forty-four patients with uni- or bilateral kidney stone disease scheduled for percutaneous nephrolithotomy were included. The preoperative pain thresholds were measured using electrical (single and 5 repeated) and pressure pain stimulation over the flank bilaterally (stone-side = operation side and control-side = non-operation side). Postoperative pain scores were recorded on a numerical rating scale and analgesic consumption was registered. The responses to repeated electrical stimuli (temporal summation) were preoperatively increased on the stone-side compared to the control-side (P = 0.016). Preoperative electrical pain thresholds from the control-side correlated inversely with postoperative opioid consumption (single stimuli: ρ = −0.43, P < 0.01; repeated stimuli: ρ = −0.45, P < 0.005). This correlation was more pronounced for the 22 patients with unilateral renal calculi (single stimuli: ρ = −0.54, P < 0.02; repeated stimuli: ρ = −0.58, P < 0.01). There were no other correlations between the preoperative sensory tests and postoperative pain or opioid consumption. This study showed a correlation between the preoperative electrical pain thresholds on the control-side and postoperative opioid consumption after percutaneous nephrolithotomy. Preoperative measurement of the electrical pain thresholds may, therefore, be useful as a screening tool to identify patients at high risk of postoperative pain.

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Acknowledgments

This work was supported by a Grant from the Local Research Foundation of Fredericia and Kolding Hospitals. Mech-Sense, Aalborg University Hospital has received funding from The Danish Council for Strategic Research.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Urological Research Center, Department of Urology, Hospital Littlebelt, University of Southern Denmark, Dronningensgade 97, 7000, Frederica, Denmark

    Katja Venborg Pedersen & Palle Jørn Sloth Osther

  2. Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark

    Anne Estrup Olesen & Asbjørn Mohr Drewes

  3. Center for Sensory-Motor Interactions (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark

    Lars Arendt-Nielsen & Asbjørn Mohr Drewes

Authors
  1. Katja Venborg Pedersen
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  2. Anne Estrup Olesen
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  3. Palle Jørn Sloth Osther
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  4. Lars Arendt-Nielsen
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  5. Asbjørn Mohr Drewes
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Correspondence to Palle Jørn Sloth Osther.

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Pedersen, K.V., Olesen, A.E., Osther, P.J.S. et al. Prediction of postoperative pain after percutaneous nephrolithotomy: can preoperative experimental pain assessment identify patients at risk?. Urolithiasis 41, 169–177 (2013). https://doi.org/10.1007/s00240-013-0547-x

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  • DOI: https://doi.org/10.1007/s00240-013-0547-x

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