Flexibility of Cognition And Persistent Pain
| Status: | Completed |
|---|---|
| Conditions: | Post-Surgical Pain |
| Therapuetic Areas: | Musculoskeletal |
| Healthy: | No |
| Age Range: | 18 - 85 |
| Updated: | 2/13/2019 |
| Start Date: | September 1, 2015 |
| End Date: | December 1, 2018 |
Cognitive Predictors of Persistent Post-surgical Pain (PPSP)
This observational study aims to determine the association between preoperative cognitive
flexibility and the risk of developing PPSP by preoperative administration of cognitive
tests.
flexibility and the risk of developing PPSP by preoperative administration of cognitive
tests.
Postoperative pain is a normal, physiologic, protective response to tissue injury that
routinely resolves after healing of the surgical site. However, in some patients, pain
persists long after surgery. PPSP is a diagnosis of exclusion that has most consistently been
defined as pain that (1) developed after a surgical procedure, (2) is not residual from a
preexisting condition, (3) has lasted for at least two months, and (4) is not attributable to
other causes. One suggested risk factor for PPSP is poorer performance on tests of cognitive
flexibility. Two common tests of cognitive flexibility are the Trail Making Tests (TMT) A and
B and the Color Word Matching Stroop Test (CWMST).
Three hundred patients undergoing either total knee arthroplasty or thoracotomy/mastectomy
will be enrolled. During preoperative evaluation, participants will complete the TMT and
CWMST. Subjects will be followed prospectively and will complete surveys at one month, six
months, and one year postoperatively to assess PPSP prevalence and intensity.
routinely resolves after healing of the surgical site. However, in some patients, pain
persists long after surgery. PPSP is a diagnosis of exclusion that has most consistently been
defined as pain that (1) developed after a surgical procedure, (2) is not residual from a
preexisting condition, (3) has lasted for at least two months, and (4) is not attributable to
other causes. One suggested risk factor for PPSP is poorer performance on tests of cognitive
flexibility. Two common tests of cognitive flexibility are the Trail Making Tests (TMT) A and
B and the Color Word Matching Stroop Test (CWMST).
Three hundred patients undergoing either total knee arthroplasty or thoracotomy/mastectomy
will be enrolled. During preoperative evaluation, participants will complete the TMT and
CWMST. Subjects will be followed prospectively and will complete surveys at one month, six
months, and one year postoperatively to assess PPSP prevalence and intensity.
Total Knee Arthroplasty (TKA) patients
- Inclusion criteria: Adults age 18 to 85 undergoing unilateral TKA for osteoarthritis
English as primary language
- Exclusion criteria: Bilateral procedure Unable to complete cognitive testing Surgical
indication for condition other than osteoarthritis (i.e. rheumatoid arthritis,
spondylarthropathy) Prior knee surgery
_________________________________________________
Thoracotomy/mastectomy patients
- Inclusion criteria: Females age 18 to 85 undergoing mastectomy for breast cancer OR
Adults age 18 to 85 undergoing unilateral open thoracotomy or video-assisted thoracoscopic
surgery (VATS) for any non-cardiac etiology English as primary language
- Exclusion criteria: Bilateral procedure Unable to complete cognitive testing Plan for
breast reconstruction Prior breast/thoracic surgery
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