BACKGROUND
Cardiac surgeries are frequent procedures. However, pain after cardiac surgery may become chronic (lasting >3 months) in adults. Once discharged from the hospital, patients are at greater risk for chronic post-surgical pain (CPSP) and prolonged opioid use, as they need to self-manage their pain. Psychological risk and protective factors, such as pain-related catastrophic thoughts and pain acceptance, will determine their ability to cope and their opioid use, which makes a support for pain self-management crucial. Studies on mindfulness-based cognitive therapy (MBCT) have multiplied regarding their potential effect on pain acceptance and catastrophic thoughts. Brief, Online MBCT for the prevention of CPSP have not been examined.
OBJECTIVE
We will pilot test a brief online 4-week MBCT intervention for adults following discharge from hospital by 1) assessing the acceptability/feasibility of the intervention; and 2) examining preliminary effects on pain intensity, pain interference with activities and opioid use, as well as pain acceptance and catastrophic thoughts in the 6 months following surgery.
METHODS
A double blinded pilot randomized controlled trial will be used to assess the online MBCT intervention. Patients will be selected according to the following criteria: a) age ≥ 18 years, b) first-time elective cardiac surgery via a median sternotomy, c) worst pain in the past week ≥4/10, d) ability to understand and complete questionnaires in English, and e) ability to use an electronic device such as a smartphone, computer, or tablet. After baseline measures, 32 participants will be randomized into two groups: one receiving both the brief 4-week online MBCT intervention and usual care (Experimental Group), the other one receiving solely one standardized educational online session with weekly reminders and usual care (Attention Control Group). Peer-reviewed competitive funding was received from the Florida State University’s Council on Research and Creativity in January 2021 as well as research ethics approval.
RESULTS
Recruitment has started in June 2021.
CONCLUSIONS
This research is significant because it targets the trajectory of CPSP, a leading cause of disability and opioid misuse. It is the first study to assess MBCT for the prevention of CPSP after cardiac surgery in the recovery phase. This approach is innovative because it promotes pain self-management through the modulation of individual factors. If successful, the intervention could be expanded to numerous populations at risk for chronic pain.
CLINICALTRIAL
NCT04848428
Randomized Controlled Trial on the Influence of Intraoperative Remifentanil versus Fentanyl on Acute and Chronic Pain after Cardiac Surgery