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.

项目概要 急性和慢性肌肉骨骼 (MSK) 疼痛是整个生命周期中重要的健康问题，而手术 是随后持续性疼痛的主要诱发事件。百分之八十的青少年正在接受 MSK 斯隆主要治疗 手术报告有严重的急性疼痛，20% 的患者会出现慢性术后疼痛。童年时患有慢性疼痛 青春期会增加 MSK 斯隆疼痛持续负面轨迹和不良健康结果的风险 成年后，加剧了国家痛苦危机。 K24 奖项将为 Dr. Rabbitts 提供重要支持， NIAMS 支持的华盛顿大学麻醉学和疼痛医学副教授 （华盛顿大学）。候选人的计划性研究重点是开发创新方法来识别 青少年 MSK 斯隆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：R01AR073780，旨在增加 了解从急性到慢性术后疼痛的转变以及所涉及的因果机制， 和 UH3HD102038（HEAL 临床试验），评估 mHealth 围手术期的有效性 心理社会干预可减少接受主要肌肉骨骼治疗的青少年的急性和慢性疼痛 外科手术。候选人将扩大她的跨专业指导计划，以建立一个强大而多元化的团队 一群疼痛科学家有能力开发和实施 MSK 斯隆疼痛危机的长期解决方案 预防。该 K24 还将允许通过以下方式扩展候选人的围手术期研究计划： 睡眠方法培训并建立新的合作，以打造一个新的研究方向，重点关注 睡觉。这两项新研究的具体目标是：1）测试疼痛处理作为 手术后青少年睡眠与后续 MSK 之间关系的中介因素 脊柱手术后 2 个月的疼痛，以及 2) 确定青少年围手术期褪黑激素的可行性 正在接受 MSK 斯隆手术。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。这将充分利用财富 SCRI 和 UW 提供的机会积极让有前途的学员参与候选人的角色 医师科学家，包括通过 SCRI 小儿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。从临床活动中释放 该奖项提供的机会将使候选人能够扩大研究员级别的受训者，同时增强 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 还加速了候选人的研究势头，告知她的 R01 和新的 U01 的 II 型更新 围手术期褪黑激素的功效试验，这对于她实现深度职业目标至关重要 了解影响机制并进行干预，以防止急性 MSK 疼痛转变为慢性疼痛。