Study Links Synthetic Opioids in Surgery to Worsened Pain Experiences
The use of powerful synthetic opioids, such as sufentanil and remifentanil, during surgery is linked to a subsequent poor 'pain experience'-a composite of emotional, cognitive, and physical aspects of pain-suggests research published in the open access journal Regional Anesthesia & Pain Medicine.
The findings highlight the need to reassess intraoperative pain relief strategies to reduce complications after surgery and improve the quality of patient care, say the researchers.
Most patients experience moderate to severe pain after surgery, which is not only unpleasant for them, but can also hinder their recovery and increase their chances of subsequent complications, explain the researchers.
Recent research suggests that the experience of pain encompasses more than intensity alone, and includes emotional and cognitive dimensions, they add.
The trial involved 1062 adults under the age of 70 at 5 French teaching hospitals. Preoperative anxiety was assessed using a validated scale (APAIS), which measures anxiety about anesthesia and surgery as well as the patient’s desire for information about the procedure. For the current study, 971 patients with EVAN-G scale scores were included in the analysis. This showed that 271 (28%) reported a poor pain experience on the first day after surgery.
“While opioids are central to perioperative analgesia, their intraoperative administration—especially of potent agents like remifentanil and sufentanil—may paradoxically contribute to heightened postoperative pain,” note the researchers, by way of an explanation for their findings.
They concluded that Aspects of pain beyond its intensity “are often overlooked, but…are critical in predicting the transition from acute to persistent postsurgical pain.
Ref: Maurice-Szamburski A, Rozier R, Gridel V, et al. Factors associated with poor pain experience after surgery. Regional Anesthesia & Pain Medicine Published Online First: 25 February 2025. doi: 10.1136/rapm-2024-106095
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