Pain after Surgery - a Research and Innovation Project

Despite improvement in pain management and constantly evolving surgical methods, pain after surgery is a persistent problem that practitioners have not been able to resolve. This project involves both research and innovation to help solve this problem.

About 30-50% of patients have more pain after surgery than is advisable. As a result, they are at increased risk for complications such as infections, heart attacks, re-admissions and chronic pain problems. This makes pain after surgery not only a problem for patients, but also for doctors and the health system at large.

Committed professionals with a background in anesthesia and emergency medicine at Helse Førde have started a new initiative that involves both research and innovation to help solve this problem.

Førde Hospital Trust and Helse Vest have funded a total of two Ph.D. projects and one regional innovation project as part of the initiative. In addition, one private company has been founded that develops equipment to improve efficiency in the collection of patient-reported pain data.

Hans Jacob Westbye is an anesthesiologist with a background in the the air ambulance and rescue helicopter services. He researches how patients can improve their own pain management after surgery, and uses patient-reported data to adapt the plan of treatment to patients’ individual needs.

In Westbye’s Ph.D. project, patients complete one survey before their surgery which, among other things, contains an adapted version of the Norse Feedback psychological assessment.

After their operation they report the pain they have, both in hospital and at home, for a period of up to three months after surgery. Before surgery, the aim of the project is to identify those patients who have a high risk of high pain after surgery.

It can give practitioners the opportunity to introduce additional measures to reduce the risk. The assessments after surgery aim to capture patients with a high risk of developing a chronic pain problem.

The ongoing risk assessment includes both patient-reported data from the pre-surgery survey and the surveys tracking the development of pain after surgery. This research should result in risk algorithms that can be implemented in clinical practice.

To increase the chance of successful implementation, Helse Vest has allocated innovation funds to develop an additional tool to make these algorithms available to health practitioners. The innovation project is led by Westbye and will involve the professional community from all over Helse Vest to develop a good platform for making the solution available.

Cecilie Merethe Øvrebotten is a nurse with a background in, among other things, the ambulance service. Over time, she has developed had a particular interest in improving pain management and wrote a master's thesis on pain management of children in the ambulance service.

In her Ph.D. project, Øvrebotten will now research how patients experience pain management after surgery, what kind of challenges they face in this work and what is needed to successfully implement a tool that can help them assess which patients are at high risk for both acute and chronic pain after surgery.

Her research is qualitative and focuses on both the therapists' and patients' experiences and needs related to pain management post-surgery.

In addition to the research project and the innovation project, a privately-owned company, Pace Healthcare, was started to develop a technological solution that can help patients become more involved in their own pain management.

Painpad is an innovative technological solution that gives patients control over pain reporting so that they can actively contribute to their own treatment. It strengthens the role of the patient participation in the treatment, at the same time as it relieves the treatment staff and ensures continuous documentation of the patients' pain.

The company is developing this technology with support from Innovation Norway and aims for a prototype can be tested in 2024.

Key information: 

Main participants: Hans Jacob WestbyeCecilie Merethe Øvrebotten
Funding: Western Regional Health Authority, Førde Hospital Trust, Helse Vest RHF (Western Norway Regional Health Authority)
Project period: 2021-2027
Cooperative institutions: Førde Hospital Trust, University of Bergen, Western Norway University of applied science, Pace Healthcare, Norse Feedback
Cristin: Kartlegging av risiko for smerte etter operasjon (In norwegian), The perioperative pain trajectory: a qualitative exploration of stakeholders’ experiences and perspectives as feasibility basis for a predictive patient-reported outcome measures system aiming to prevent chronic postsurgical pain (MAPIP-FEAS)