Associate Professor, Departments of Biostatistics and Anesthesia, University of Iowa, Iowa City, Iowa.
Professor, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.
J Pain. 2021 Aug;22(8):892-904. doi: 10.1016/j.jpain.2021.03.148. Epub 2021 Apr 10.
Patients undergoing thoracic surgery experience particular challenges for acute pain management. Availability of standardized diagnostic criteria for identification of acute pain after thoracotomy and video assisted thoracic surgery (VATS) would provide a foundation for evidence-based management and facilitate future research. The Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership with the United States Food and Drug Administration, the American Pain Society (APS), and the American Academy of Pain Medicine (AAPM) formed the ACTTION-APS-AAPM Pain Taxonomy (AAAPT) initiative to address absence of acute pain diagnostic criteria. A multidisciplinary working group of pain experts was invited to develop diagnostic criteria for acute thoracotomy and VATS pain. The working group used available studies and expert opinion to characterize acute pain after thoracotomy and VATS using the 5-dimension taxonomical structure proposed by AAAPT (i.e., core diagnostic criteria, common features, modulating factors, impact/functional consequences, and putative mechanisms). The resulting diagnostic criteria will serve as the starting point for subsequent empirically validated criteria. PERSPECTIVE ITEM: This article characterizes acute pain after thoracotomy and VATS using the 5-dimension taxonomical structure proposed by AAAPT (ie, core diagnostic criteria, common features, modulating factors, impact and/or functional consequences, and putative mechanisms).
接受胸外科手术的患者在急性疼痛管理方面面临特殊挑战。如果有标准化的诊断标准可用于确定开胸手术后和电视辅助胸腔镜手术后的急性疼痛,将为循证管理提供基础,并为未来的研究提供便利。镇痛、麻醉和成瘾临床试验转化、创新、机遇和网络(ACTION)与美国食品和药物管理局、美国疼痛协会(APS)和美国疼痛医学学院(AAPM)的公私合作伙伴关系,成立了 ACTION-APS-AAPM 疼痛分类法(AAAPT)倡议,以解决急性疼痛诊断标准缺失的问题。一个多学科疼痛专家工作组应邀制定急性开胸和胸腔镜手术后疼痛的诊断标准。该工作组利用现有研究和专家意见,采用 AAAPT 提出的 5 维分类结构(即核心诊断标准、常见特征、调节因素、影响/功能后果和推测机制)来描述开胸和胸腔镜手术后的急性疼痛。由此产生的诊断标准将作为随后经验验证标准的起点。观点项目:本文采用 AAAPT 提出的 5 维分类结构(即核心诊断标准、常见特征、调节因素、影响和/或功能后果以及推测机制)来描述开胸和胸腔镜手术后的急性疼痛。