Preemptive Analgesia in Recovery from Hysterectomy

描述（由申请人提供）：超过2300万的一半 外科手术伴随着未充分治疗的疼痛。疼痛 干扰身体功能，如呼吸，血压调节， 它抑制了病人参与的能力， 术后护理方案，并明显增加术后 呼吸系统并发症出院后，疼痛控制不良 继续折磨着病人手术带来的疼痛会导致 中枢神经系统致敏性慢性疼痛综合征 （CNS）。我们选择经腹子宫切除术（TAH）作为模型 手术，因为每年有60万名妇女接受直肠切除术，而妇女的手术量更大。 易患慢性疼痛综合症。 超前镇痛是一种旨在减少疼痛和改善 通过在手术前开始镇痛方案使患者从手术中恢复， 疼痛刺激的发作。有明确的动物基础研究和 越来越多的人体临床研究表明，超前镇痛可以减少 手术后的疼痛和镇痛需求。最近的工作扩展了证明 的好处的形式减少疼痛和增加活动后， 出院这项研究申请建议检查 硬膜外主动超前镇痛的短期和长期益处 住院期间和出院后接受TAR疼痛的患者， 活动水平，并恢复术前功能将定量 通过有效的结果测量进行评估。 奥罗克博士，麻醉学助理教授，在大学的 宾夕法尼亚州，正在申请临床研究者奖（K23），以追求 专注于提高手术后的恢复能力他有一个严重的 他对这一领域的兴趣体现在他参与目前和拟议的 research.此应用程序请求支持，以允许他进行 全面的职业发展计划，包括：1）在硕士 生物统计学和流行病学，由Brian Strom博士指导，2）a 研究导师船与博士约翰·法勒和艾伦Gottschalk和马克 （3）研究计划。这些活动将提供 他的技能和经验，以追求一个成功的职业生涯的意义 作为独立调查员资助的研究。

DESCRIPTION (provided by applicant): Over half of the over 23 million surgical procedures are accompanied by inadequately treated pain. Pain interferes with bodily functions such as breathing, blood pressure regulation, digestion etc. It inhibits the patient s ability to participate in postoperative care regimens, and clearly increases the risk of postoperative respiratory complications. After discharge, the poorly controlled pain continues to plague patients. The pain associated with surgery can lead to chronic pain syndromes due to sensitization of the central nervous system (CNS). We have chosen to use trans-abdominal hysterectomy (TAH) as a model operation because 600,000 women a year have hysterectomies, and women are more prone to suffering chronic painful syndromes. Preemptive analgesia is an intervention designed to decrease pain and improve patient recovery from surgery by initiating an analgesic regimen prior to the onset of the painful stimuli. There is clear animal based research and a growing body of human clinical research that preemptive analgesia can reduce pain and analgesic needs following surgery. Recent work has extended the proof of benefits in the form of decreased pain and increased activity to well after discharge from the hospital. This research application proposes to examine the short- and long-term benefits of aggressive preemptive epidural analgesia in patients undergoing TAR Pain during hospitalization and after discharge, activity levels, and return to preoperative function will be quantitatively assessed with validated outcome measures. Dr. Ochroch, an Assistant Professor of Anesthesiology at the University of Pennsylvania, is applying for a Clinical Investigator Award (K23) to pursue an academic career focusing on improving recovery from surgery. He has a serious interest in this area as evidenced by his involvement in current and proposed research. This application requests support to allow him to undertake a comprehensive career development program including: 1) a Masters in Biostatistics and Epidemiology under the mentorship of Dr. Brian Strom, 2) a research preceptor ship with Drs. John Farrar and Allan Gottschalk and Mark Morgan, and 3) the proposed research project. These activities will provide him with the skills and experience to pursue a successful career of meaningful funded research as an independent investigator.