Acute Postoperative Pain Trajectory Groups: Reply

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, although we 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 (fig. 1, with numbers from Table 3 in the 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 that we were able to contribute to this important clinical topic.

The work for the published article was supported by the National Institutes of Health (Bethesda, Maryland; grant No. R01 GM114290 to Dr. Tighe) and the Donn M. Dennis, M.D., Professorship in Anesthetic Innovation, University of Florida (Gainesville, Florida; to Dr. Tighe).

The authors declare no competing interests.