Preventing the Transition from Acute to Chronic Musculoskeletal Pain in Adolescents after Surgery: The Role of Sleep

防止青少年手术后从急性肌肉骨骼疼痛转变为慢性肌肉骨骼疼痛：睡眠的作用

• 批准号: 10879417
• 负责人: Jennifer Rabbitts
• 金额: $ 17.97万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2028-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10879417
• 关键词: Acceleration; Acute; Acute Pain; Address; Adherence; Adolescence; Adolescent; Adult; Age; Anesthesiology; Anxiety; Applications Grants; Award; Childhood; Chronic; Clinical; Clinical Trials; Collaborations; Complementary therapies; Data; Dose; Enrollment; Enteral; Epidemic; Event; Fellowship; Funding; Generations; Health; Hormones; Intervention; Knowledge; Link; Longevity; Mediating; Mediator; Medicine; Melatonin; Mentors; Mentorship; Methodology; Methods; Mid-Career Clinical Scientist Award (K24); Midcareer Investigator Award in Patient-Oriented Research; Modeling; Monitor; Musculoskeletal; Musculoskeletal Pain; National Institute of Arthritis, and Musculoskeletal, and Skin Diseases; Needles; Operative Surgical Procedures; Outcome; Pain; Pain Research; Pain intensity; Pain interference; Parents; Pathway interactions; Perioperative; Persistent pain; Physicians; Population; Postdoctoral Fellow; Postoperative Pain; Postoperative Period; Prevention; Psychophysics; Public Health; Reporting; Research; Research Personnel; Research Project Grants; Research Support; Risk; Risk Factors; Risk Marker; Role; Safety; Science; Scientist; Sleep; Sleep Wake Cycle; Sleep disturbances; Spinal Fusion; Spine surgery; Teenagers; Testing; Time; Training; Training Programs; Universities; Washington; Youth; acceptability and feasibility; biopsychosocial; career; chronic musculoskeletal pain; chronic pain; clinical pain; cohort; effectiveness evaluation; efficacy testing; efficacy trial; experience; feasibility trial; fibromyalgia patients; follow-up; forging; health goals; health related quality of life; high risk; improved; improvement on sleep; innovation; longitudinal design; mHealth; mid-career faculty; minimal risk; modifiable risk; next generation; non-opioid analgesic; novel; pain chronification; pain processing; pain reduction; pain sensitivity; patient oriented; pilot trial; poor health outcome; prevent; preventive intervention; primary outcome; programs; psychosocial; research study; resilience; resilience factor; secondary outcome; sensory mechanism; sex; side effect; skills; sleep quality; sleep regulation; training opportunity

PROJECT SUMMARY Acute and chronic musculoskeletal (MSK) pain are important health concerns across the lifespan, and surgery is a chief inciting event for subsequent persistent pain. Eighty percent of adolescents undergoing major MSK surgery report severe acute pain, and 20% develop chronic postsurgical pain. Having chronic pain in childhood and adolescence increases risk for a continued negative trajectory of MSK pain and poor health outcomes in adulthood, contributing to the national pain crisis. This K24 award will provide critical support for Dr. Rabbitts, a NIAMS-supported Associate Professor of Anesthesiology and Pain Medicine at the University of Washington (UW). The candidate's programmatic research has focused on developing innovative methods to identify biopsychosocial contributors to acute and chronic pain following MSK surgery in adolescents. During the course of this award, she will complete currently supported research: R01AR073780 which aims to increase understanding of the transition from acute to chronic postsurgical pain and the causal mechanisms involved, and UH3HD102038 (HEAL clinical trial) which evaluates the effectiveness of an mHealth perioperative psychosocial intervention to reduce acute and chronic pain in adolescents undergoing major musculoskeletal surgery. The candidate will expand her interprofessional mentoring program to build a strong and diverse cohort of pain scientists equipped to develop and implement long-term solutions to the MSK pain crisis through prevention. This K24 will also allow extension of the candidate's perioperative research program through training in sleep methodologies and building new collaborations to forge a novel research direction focused on sleep. The specific aims of the two new research studies proposed are to: 1) test pain processing as a mediator in the relationship between adolescent sleep immediately following surgery and subsequent MSK pain at 2 months after spine surgery, and 2) to determine feasibility of peri-operative melatonin in youth undergoing MSK surgery. The four projects will provide mentees with rigorous methodological training in a broad range of pain research assessment and intervention methods. This will capitalize on the wealth of opportunities available at SCRI and UW to actively engage promising trainees in the candidate's role as a physician-scientist, including via the SCRI Pediatric Pain Research Postdoctoral Fellowship and the UW T32 Training Program in Anesthesiology and Perioperative Medicine Research. Release from clinical activities provided by this award will allow the candidate to expand mentees at the fellow level, while enhancing mentorship skills, to equip a new generation of pain researchers with necessary scientific and professional skills, resiliency, and commitment to pain science, to make a sustained impact on the pain crisis. The K24 will also accelerate the candidate's research momentum informing the Type II renewal of her R01 and a new U01 efficacy trial of perioperative melatonin, which will be critical to her career objectives to achieve a deep understanding of contributing mechanisms and intervening to prevent acute to chronic MSK pain transition.

项目摘要 急性和慢性肌肉骨骼（MSK）疼痛是整个生命周期的重要健康问题， 是继发性持续性疼痛的主要诱因。80%的青少年接受主要MSK 手术报告了严重急性疼痛，20%发展为慢性术后疼痛。童年时有慢性疼痛 和青春期增加了持续的MSK疼痛和不良健康结果的负面轨迹的风险， 成年期，导致国家疼痛危机。这个K24奖项将为Dr. Rabbitts提供关键支持， 华盛顿大学麻醉学和疼痛医学副教授 （UW）。候选人的方案研究侧重于开发创新方法，以确定 青少年MSK手术后急性和慢性疼痛的生物心理社会因素期间 在获得该奖项的过程中，她将完成目前支持的研究：R 01 AR 073780，旨在增加 了解从急性到慢性术后疼痛的转变以及相关的因果机制， 和UH 3 HD 102038（HEAL临床试验），其评估了mHealth围手术期的有效性 心理社会干预以减少青少年接受主要肌肉骨骼手术的急慢性疼痛 手术候选人将扩大她的跨专业辅导计划，以建立一个强大的和多样化的 一群疼痛科学家，通过以下方式开发和实施MSK疼痛危机的长期解决方案： 预防该K24还将允许候选人的围手术期研究计划的扩展， 睡眠方法的培训和建立新的合作，以打造一个新的研究方向，重点是 睡吧这两项新研究的具体目标是：1）测试疼痛处理作为一种 青少年手术后睡眠与后续MSK之间关系的中介 脊柱手术后2个月的疼痛，以及2）确定青年围手术期褪黑激素的可行性 接受MSK手术这四个项目将为学员提供严格的方法培训， 广泛的疼痛研究评估和干预方法。这将充分利用 在SCRI和UW提供的机会，积极吸引有前途的学员在候选人的角色， 医生-科学家，包括通过SCRI儿科疼痛研究博士后奖学金和UW T32 麻醉学和围手术期医学研究培训计划。临床活动放行 这一奖项提供的将允许候选人扩大学员在研究员一级，同时提高 指导技能，为新一代疼痛研究人员提供必要的科学和专业知识， 技能，弹性和对疼痛科学的承诺，对疼痛危机产生持续的影响。K24将 还加快候选人的研究势头，通知她的R 01和新的U 01的II型更新 围手术期褪黑激素的功效试验，这对于她实现深入的职业目标至关重要 了解促成机制并进行干预，以防止急性MSK疼痛向慢性转变。