Research gaps in practice guidelines for acute postoperative pain management in adults

Findings from a review of the evidence for an American pain society clinical practice guideline

Debra B. Gordon, Oscar A. De Leon-Casasola, Christopher L. Wu, Kathleen A. Sluka, Timothy J. Brennan, Roger Chou

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Acute postoperative pain is a common clinical condition that, when poorly controlled, can result in a number of significant negative consequences. The American Pain Society commissioned an evidence-based guideline on the management of postoperative pain to promote evidence-based, safe, and effective perioperative pain management. An interdisciplinary panel developed 31 key questions and inclusion criteria to guide the evidence review. Investigators reviewed 6556 abstracts from multiple electronic databases up to November 2012, an updated evidence review to October 2014, and key references suggested by expert reviewers. More than 800 primary studies not included in a systematic review and 107 systematic reviews were included. Despite a large body of evidence, a number of critical research gaps were identified where only low-quality or insufficient evidence was found to help guide clinical practice recommendations. This report identifies evidence gaps including optimal methods and timing of perioperative patient education, nonpharmacological modalities, combinations of analgesic techniques, monitoring of patient response to treatment, techniques for neuraxial and regional analgesia, and organizational care delivery models. Recommendations to help guide the design of future perioperative studies are offered. Perspective Acute postoperative pain is a common clinical condition requiring an evidence-based, planned, and multimodal approach. Despite the plethora of published evidence, much of it is weak and key questions remain unanswered. Researchers are encouraged to work together to produce strong evidence to help guide clinical decisions in perioperative pain management.

Original languageEnglish (US)
Pages (from-to)158-166
Number of pages9
JournalJournal of Pain
Volume17
Issue number2
DOIs
StatePublished - Feb 1 2016

Fingerprint

Acute Pain
Pain Management
Postoperative Pain
Practice Guidelines
Pain
Research
Research Personnel
Physiologic Monitoring
Patient Education
Analgesia
Analgesics
Databases
Guidelines
Therapeutics

Keywords

  • Acute pain
  • evidence-based guideline
  • postoperative pain
  • research gaps
  • systematic review

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Neurology
  • Clinical Neurology

Cite this

Research gaps in practice guidelines for acute postoperative pain management in adults : Findings from a review of the evidence for an American pain society clinical practice guideline. / Gordon, Debra B.; De Leon-Casasola, Oscar A.; Wu, Christopher L.; Sluka, Kathleen A.; Brennan, Timothy J.; Chou, Roger.

In: Journal of Pain, Vol. 17, No. 2, 01.02.2016, p. 158-166.

Research output: Contribution to journalArticle

Gordon, Debra B. ; De Leon-Casasola, Oscar A. ; Wu, Christopher L. ; Sluka, Kathleen A. ; Brennan, Timothy J. ; Chou, Roger. / Research gaps in practice guidelines for acute postoperative pain management in adults : Findings from a review of the evidence for an American pain society clinical practice guideline. In: Journal of Pain. 2016 ; Vol. 17, No. 2. pp. 158-166.
@article{773b8b7167ff47d9bc08900d86aae62e,
title = "Research gaps in practice guidelines for acute postoperative pain management in adults: Findings from a review of the evidence for an American pain society clinical practice guideline",
abstract = "Acute postoperative pain is a common clinical condition that, when poorly controlled, can result in a number of significant negative consequences. The American Pain Society commissioned an evidence-based guideline on the management of postoperative pain to promote evidence-based, safe, and effective perioperative pain management. An interdisciplinary panel developed 31 key questions and inclusion criteria to guide the evidence review. Investigators reviewed 6556 abstracts from multiple electronic databases up to November 2012, an updated evidence review to October 2014, and key references suggested by expert reviewers. More than 800 primary studies not included in a systematic review and 107 systematic reviews were included. Despite a large body of evidence, a number of critical research gaps were identified where only low-quality or insufficient evidence was found to help guide clinical practice recommendations. This report identifies evidence gaps including optimal methods and timing of perioperative patient education, nonpharmacological modalities, combinations of analgesic techniques, monitoring of patient response to treatment, techniques for neuraxial and regional analgesia, and organizational care delivery models. Recommendations to help guide the design of future perioperative studies are offered. Perspective Acute postoperative pain is a common clinical condition requiring an evidence-based, planned, and multimodal approach. Despite the plethora of published evidence, much of it is weak and key questions remain unanswered. Researchers are encouraged to work together to produce strong evidence to help guide clinical decisions in perioperative pain management.",
keywords = "Acute pain, evidence-based guideline, postoperative pain, research gaps, systematic review",
author = "Gordon, {Debra B.} and {De Leon-Casasola}, {Oscar A.} and Wu, {Christopher L.} and Sluka, {Kathleen A.} and Brennan, {Timothy J.} and Roger Chou",
year = "2016",
month = "2",
day = "1",
doi = "10.1016/j.jpain.2015.10.023",
language = "English (US)",
volume = "17",
pages = "158--166",
journal = "Journal of Pain",
issn = "1526-5900",
publisher = "Churchill Livingstone",
number = "2",

}

TY - JOUR

T1 - Research gaps in practice guidelines for acute postoperative pain management in adults

T2 - Findings from a review of the evidence for an American pain society clinical practice guideline

AU - Gordon, Debra B.

AU - De Leon-Casasola, Oscar A.

AU - Wu, Christopher L.

AU - Sluka, Kathleen A.

AU - Brennan, Timothy J.

AU - Chou, Roger

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Acute postoperative pain is a common clinical condition that, when poorly controlled, can result in a number of significant negative consequences. The American Pain Society commissioned an evidence-based guideline on the management of postoperative pain to promote evidence-based, safe, and effective perioperative pain management. An interdisciplinary panel developed 31 key questions and inclusion criteria to guide the evidence review. Investigators reviewed 6556 abstracts from multiple electronic databases up to November 2012, an updated evidence review to October 2014, and key references suggested by expert reviewers. More than 800 primary studies not included in a systematic review and 107 systematic reviews were included. Despite a large body of evidence, a number of critical research gaps were identified where only low-quality or insufficient evidence was found to help guide clinical practice recommendations. This report identifies evidence gaps including optimal methods and timing of perioperative patient education, nonpharmacological modalities, combinations of analgesic techniques, monitoring of patient response to treatment, techniques for neuraxial and regional analgesia, and organizational care delivery models. Recommendations to help guide the design of future perioperative studies are offered. Perspective Acute postoperative pain is a common clinical condition requiring an evidence-based, planned, and multimodal approach. Despite the plethora of published evidence, much of it is weak and key questions remain unanswered. Researchers are encouraged to work together to produce strong evidence to help guide clinical decisions in perioperative pain management.

AB - Acute postoperative pain is a common clinical condition that, when poorly controlled, can result in a number of significant negative consequences. The American Pain Society commissioned an evidence-based guideline on the management of postoperative pain to promote evidence-based, safe, and effective perioperative pain management. An interdisciplinary panel developed 31 key questions and inclusion criteria to guide the evidence review. Investigators reviewed 6556 abstracts from multiple electronic databases up to November 2012, an updated evidence review to October 2014, and key references suggested by expert reviewers. More than 800 primary studies not included in a systematic review and 107 systematic reviews were included. Despite a large body of evidence, a number of critical research gaps were identified where only low-quality or insufficient evidence was found to help guide clinical practice recommendations. This report identifies evidence gaps including optimal methods and timing of perioperative patient education, nonpharmacological modalities, combinations of analgesic techniques, monitoring of patient response to treatment, techniques for neuraxial and regional analgesia, and organizational care delivery models. Recommendations to help guide the design of future perioperative studies are offered. Perspective Acute postoperative pain is a common clinical condition requiring an evidence-based, planned, and multimodal approach. Despite the plethora of published evidence, much of it is weak and key questions remain unanswered. Researchers are encouraged to work together to produce strong evidence to help guide clinical decisions in perioperative pain management.

KW - Acute pain

KW - evidence-based guideline

KW - postoperative pain

KW - research gaps

KW - systematic review

UR - http://www.scopus.com/inward/record.url?scp=84959257523&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84959257523&partnerID=8YFLogxK

U2 - 10.1016/j.jpain.2015.10.023

DO - 10.1016/j.jpain.2015.10.023

M3 - Article

VL - 17

SP - 158

EP - 166

JO - Journal of Pain

JF - Journal of Pain

SN - 1526-5900

IS - 2

ER -