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New PAIN OUT publication: Non-Pharmacological Methods and Post-Operative Pain Relief: An Observational Study

Results from PAIN OUT data regarding the effect of non-pharmacological methods for pain treatment published in Anesth. Pain Med. doi: 10.5812/aapm.84674.


Background: Non-pharmacological methods (NPMs) like cold packs, acupuncture, meditation or distractions are supposed to ease
acute post-surgical pain.
Objectives: This study assessed how frequently these methods are used in clinical routine and if their use is associated with pain
relief or with the wish for more pain treatment.
Methods: Data from the world’s largest acute post-operative pain registry, PAIN OUT, was used for this study. In PAIN OUT, patients
report their pain levels and side effects related to pain therapy after surgery. Overall, 15 different NPMs were tested for their association
with pain relief and the wish for more pain treatment using Mann-Whitney U test, Kruskal-Wallis test, General Linear Model,
and Logistic Regression. The researchers adjusted for age and gender, and specifically looked at the three most frequent surgeries:
total knee replacement, total hip replacement, and laparoscopic cholecystectomy.
Results: Data of 14 767 patients from 12 European hospitals were analyzed. Overall, 6563 (44.4%) patients used at least one NPM;
with distraction and cold packs being the most frequently used. The 8204 (55.6%) patients, who did not use NPMs had little yet
significantly more pain relief than patients, who used them (means of 71.2% 27.9% versus 68.6% 25.7%, P < 0.001). Using NPMs
does not affect the wish for more pain treatment. This is true for every single NPM. The only exceptional sub-group included total
knee replacement patients, where a positive effect of NPMs was observed.
Conclusions: Some NPMs are widely used while others are rarely applied. Their association with pain relief is doubtful. These
findings add to a rather contradictory literature. Advantages and disadvantages of applying NPMs solely for pain relief should thus
be considered carefully.