We sincerely thank Drs. Kehlet and Foss1 for their commentary on our study2 of the determinants of postoperative pain trajectories. The authors correctly highlight that, while were able to provide a detailed analysis of pre- and intraoperative characteristics, our study did not robustly characterize postoperative pain management and its relation to postoperative pain trajectories. In the analysis we were able to perform and present, we provided support for a relationship between postoperative opioid requirement and postoperative pain trajectory (Kruskal-Wallis H=54.8, df=4, p < 0.001), with patients in the higher pain trajectories requiring greater postoperative opioids (Figure 1, with numbers from Table 3 in original article2). However, as the authors note, with our heterogenous patient sample, there was similar heterogeneity in postoperative pain management, limiting our analysis. We agree with the authors that studies with more homogenous patient populations regarding procedure type, would be better able to characterize perioperative pain management and how it is related to postoperative pain trajectories. We are excited we were able to contribute to this important clinical topic.
Figure 1.
Box plot of total postoperative opioids stratified by postoperative pain trajectory group. Labels indicate median value.
Funding:
The work for published article was supported by the National Institutes of Health (grant no. R01 GM114290 to P.J.T.) and the Donn M. Dennis MD Professorship in Anesthetic Innovation (P.J.T.).
Footnotes
Conflict of interest statement: The authors have no conflicts of interest to declare.
Reference
- 1.Kehlet H and Foss NB; “Patient and Procedural Determinants of Postoperative Pain Trajectories?” (Re: Vasilopoulos et al et al. Anesthesiology 2021. [March]; 134: 421–34). Anesthesiology 2021 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Vasilopoulos T, Wardhan R, Rashidi P, Fillingim RB, Wallace MR, Crispen PL, Parvataneni HK, Prieto HA, Machuca TN, Hughes SJ, Murad GJA, Tighe PJ; Temporal Postoperative Pain Signatures (TEMPOS) Group. Patient and Procedural Determinants of Postoperative Pain Trajectories. Anesthesiology 2021; 134: 421–34. [DOI] [PMC free article] [PubMed] [Google Scholar]