Evidence map›Paper›PMID 40781814›Full record

Observational studyPain practice : the official journal of World Institute of Pain2025

Painfully Obvious? Non-Operative Drivers of Post-Operative Pain and Opioid Exposure in a Predominantly Emergency Surgical Cohort: A Multicentre Observational Study Identifying Non-Operative, Perioperative Pain Correlates.

Brandon Stretton, Andrew E C Booth, Joshua Kovoor, Aashray Gupta, Ammar Zaka, Suzanne Edwards, Gerry O'Callaghan, Gregory B Crawford, Danny Liew, Guy Maddern and 1 more

Abstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Pain practice : the official journal of World Institute of Pain, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Brandon StrettonAdelaide Medical School, Faculty of Health and Medical Science, University of Adelaide, Adelaide, South Australia, Australia.ORCID https://orcid.org/0000-0002-7939-3489
Andrew E C BoothAdelaide Medical School, Faculty of Health and Medical Science, University of Adelaide, Adelaide, South Australia, Australia.
Joshua KovoorBallarat Base Hospital, Ballarat Central, Victoria, Australia.
Aashray GuptaDepartment of Cardiothoracic Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Ammar ZakaGold Coast University Hospital, Southport, Queensland, Australia.
Suzanne EdwardsAdelaide Health Technology Assessment, The University of Adelaide, Adelaide, South Australia, Australia.
Gerry O'CallaghanAdelaide Medical School, Faculty of Health and Medical Science, University of Adelaide, Adelaide, South Australia, Australia.
Gregory B CrawfordAdelaide Medical School, Faculty of Health and Medical Science, University of Adelaide, Adelaide, South Australia, Australia.
Danny LiewAdelaide Medical School, Faculty of Health and Medical Science, University of Adelaide, Adelaide, South Australia, Australia.
Guy MaddernAdelaide Medical School, Faculty of Health and Medical Science, University of Adelaide, Adelaide, South Australia, Australia.
Stephen BacchiNorthern Adelaide Local Health Network, Adelaide, South Australia, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThere are many non-operative factors (patient specific and management strategies) that are ubiquitous across all surgeries, which may influence perioperative pain. Recognition of these factors and their association with pain and analgesia requirements could provide avenues for improved perioperative care.

methodsAll consecutive surgical patients admitted to six Australian tertiary hospitals (2017-2024) were included. The primary outcome was postoperative pain score (0 = no pain to 10 = unbearable pain). Additional outcomes included "Pain Crisis", quantity of postoperative and discharge analgesia. Pain scores were calculated using the median scores in the 5 days postoperatively. Postoperative analgesia was quantified by total morphine milligram equivalents (MME) in the 5 days postoperatively and discharge analgesia as MME provided on the discharge prescription. Multivariable binary logistic and linear regression models, with backward elimination, were employed with clinical characteristics and non-operative management factors included as predictors.

resultsA total of 37,278 patients were included. Of these, 92% were unplanned emergency procedures. Psychological factors, such as depression and anxiety, significantly influenced perioperative pain and opioid use. An increase in socio-economic status was associated with less postoperative analgesia but more discharge analgesia. Older patients generally experienced less pain and required fewer opioids. Contrastingly, increased frailty correlated with higher opioid usage. Patients speaking English as a primary language reported more postoperative pain, without higher opioid use. Patients who did not identify as a First Nations Australian received 30% more opioids on discharge, despite no relationship with pain. DISCUSSION/

conclusionAn integrated, anticipatory, patient-centric approach to perioperative pain and analgesia that considers not only the surgical factors but also the individual's psychological and socio-economic context is required.

Indexed as

Analgesics, OpioidPostoperative PainAdultAgedAustraliaCohort StudiesFemaleHumansMaleMiddle AgedPain ManagementPain MeasurementAnalgesics, Opioidanalgesiaopiate prescriptionopioidperioperative analgesiaperioperative pain

Identifiers

PMID40781814
PMCPMC12334907

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.