Post-surgical pain is moderate or severe in more than 50% of the 40 million surgeries performed each year in North America. While pain is an important problem, evidence suggests that pain also contributes to other post-surgical complications. Over the past decade, continued PSI Foundation support has accelerated my study in post-surgical pain mechanisms and treatments in the Clinical Pain Research program at Queen’s University.
The findings have demonstrated that movement-related pain impairs post-surgical recovery of lung function. Despite the importance of movement-related pain, our recent systematic review showed that this outcome measure is too often neglected, and should be considered in all future post-surgical pain trials. In the interest of improving treatment, we have shown that combining two non-opioid drugs (gabapentin plus either rofecoxib or meloxicam) is superior to either drug alone for reducing pain or opioid-related side-effects. The Foundations valuable support of this program has enriched our background and expertise in the study of post-operative pain treatments and led to systematic reviews of COX-2 inhibitors and anticonvulsant drugs.
My latest PSI award involved a trial to evaluate a triple non-opioid drug combination to better treat pain after surgery. The results of this trial did not provide strong support for the superiority of a triple drug combination over a double drug combination for acute postoperative pain and illustrate the complexities of polypharmacy and multimodal analgesia.
Thanks to research expertise, resources and vision of the PSI Foundation, this research program will continue to advance and disseminate knowledge that will help guide patient-care improvements in Ontario, Canada, and beyond.