Institute for Pain Research & Care Graduate Studentships Maram Khaled, BSc, DC, MSc PhD Candidate Project Title: Postsurgical Pain and Neurocognitive Outcomes After Non-Cardiac Surgery in Older Adults Supervisor: Dr. Maura Marcucci
Brief Overview and Progress to Date Chronic postsurgical pain (CPSP) may increase the risk of postoperative cognitive dysfunction (POCD) directly or through negatively impacting mobility. A comprehensive measure of satisfaction with surgery that accounts for ability to perform activities might be even more strongly associated with POCD. There might be complex mechanisms underlying the interplays between postoperative pain and cognition. In this prospective cohort study we aim to explore whether CPSP at 6 months is associated with POCD (≥2-point decline in the Montreal Cognitive Assessment (MoCA) compared to preoperative) at 12 months. We will also explore the association between satisfaction with surgery and POCD; the role of pain medications (opioids) in the association between CPSP and POCD; the role of patient preoccupation /optimism and coping in determining the effect of pain on cognition; and the hypothesis of neurogenesis-interference as an underlying mechanism. Patients ≥50 years old undergoing elective total knee/hip arthroplasty are included. Socio-demographics, comorbidities, pain, and pain
“The ArthroCaP study will provide important insight into the association of chronic postsurgical pain and patient satisfaction with postoperative cognitive dysfunction and underlying mechanisms. It will inform larger confirmatory and interventional studies to enhance perioperative care.” - Maram Khaled
medications are assessed preoperatively. Patients are followed upto 12 months postoperatively to measure coping (SPOC questionnaire), pain and satisfaction. MoCA and neuropsychological tests are administered at baseline, 4-6 weeks, 6 and 12 months. Blood is longitudinally collected for biomarker analysis. Recruitment has been completed with 80 participants enrolled in the study. So far, 22 participants have completed the study.
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