A Systematic Review of Postoperative Pain Outcome Measurements Utilised in Regional Anesthesia Randomized Controlled Trials

Table 1

Summary of measurement timings of pain outcomes utilised in included studies.

Author/year	Country of study	Measurement tool	Time measured	Nerve block
Ambrosoli et al. [12]	Not stated	NRS (not stated; 0–10)	4 hours post-op	Sciatic nerve catheter
			Upon discharge
		NRS at rest (0–10)	24 hours
			48 hours
		NRS on activity (0–10)	24 hours
			48 hours
		Number of occasions sleep was disturbed by pain	24 hours
			48 hours
Andersen et al. [13]	Denmark	Worst pain during knee movement	On day of surgery	Saphenous nerve block
		VAS (10 cm) at rest
		Time from surgery to VAS score 3 (not stated)	Hours
		Sleep disturbance due to pain (yes/no)	D1 post-op
			D2 post-op
			D3 post-op
		Total opioid consumption	48 hours
Bengisun et al. [39]	Turkey	VAS (10 cm; not stated)	2 hours post-op	Interscalene block
			4 hours post-op
			6 hours post-op
			12 hours post-op
			24 hours post-op
Bharti et al. [14]	India	VAS (10 cm; not stated)	Every 30 min for 2 hours	Supraclavicular brachial plexus block
			Every 1 hour for 6 hours
			Every 2 hours for 12 hours
			24 hours post-op
		Total analgesic requirement (opiate and nonopiate)	24 hours post-op
Boussofara et al. [15]	Tunisia	VAS (10 cm; not stated)	Every 15 min post-op whilst in PACU	Spinal anaesthetic block
		Total opioid consumption	Whilst in PACU
Capdevilla et al. [16]	France	VAS (10 cm; not stated)	10 min post-op	Interscalene and popliteal infusions
			1 hour post-op
			4 hours post-op
			12 hours post-op
			AM D1 post-op during physiotx
			AM D2 post-op during physiotx
			AM D3 post-op during physiotx
			AM D4 post-op during physiotx
		Total analgesic consumption (nonopiate)	Over 72 hours
Choi et al. [17]	Canada	NRS on activity (0–10)	AM D2 post-op	Femoral nerve block continuous versus single
		Total opioid consumption	48 hours
		NRS at rest (0–10)	AM D1 post-op
		NRS on activity (0–10)	D1 post-op
		Worst NRS (0–10)	D1 post-op
		NRS (0–10; not stated)	4.5 months post-op
Diakomi et al. [18]	Greece	Time to first IV opioid request (hours)	No. of hours	Fascia iliaca block
		Total opioid consumption	Over first 24 hours
Elkassabany et al. [19]	USA	Pain scores (type of pain score not stated)	Before physiotherapy	Femoral nerve block versus adductor canal block
		Pain scores (type of pain score not stated)	After physiotherapy
		Pain scores (APS-POQ-R)	At 24 hours
		Total opioid consumption	AM D1 post-op
			AM D2 post-op
Fredrickson et al. [20]	New Zealand	NRS (not stated; 0–10)	Emergence	Interscalene catheters
			Worst in 24 hours on movement
			Worst in 24 hours at rest
			Worst in second 24 hours on movement
			Worst in second 24 hours at rest
Fritsch et al. [21]	Austria	NRS at rest (0–10)	4 hours post-op	Interscalene brachial plexus block
			6 hours post-op
			8 hours post-op
			10 hours post-op
			12 hours post-op
			14 hours post-op
		NRS on activity (0–10)	4 hours post-op
			6 hours post-op
			8 hours post-op
			10 hours post-op
			12 hours post-op
			14 hours post-op
Hamdani et al. [38]	Switzerland	Average pain score (NRS; 0–10) (not stated)	Over first 24 hours	Continuous interscalene
		Average pain score (NRS; 0–10) (not stated)	Over first 48 hours
		Total opioid consumption	Over first 24 hours
		Total opioid consumption	Over first 48 hours
		Maximum pain score (NRS; 0–10) (not stated)	Over first 24 hours
		Maximum pain score (NRS; 0–10) (not stated)	Over first 48 hours
Karthikeyan et al. [37]	India	VAS (10 cm) (not stated)	Admission to PACU	Bilateral cervical plexus block
			2 hours post-op
			4 hours post-op
			6 hours post-op
			8 hours post-op
			16 hours post-op
			24 hours post-op
		Time to first analgesic request	Min
		Total analgesic consumption (opioid consumption)	24 hours post-op
Kim et al. [42]	Republic of Korea	VAS (10 cm; not stated)	1 hour post-op	Serratus-intercostal plane block and intermediate cervical plexus block versus control
			3 hours post-op
			6 hours post-op
			9 hours post-op
			24 hours post-op
Kulhari et al. [36]	Not stated	Time to first rescue analgesia	After administration of block	Pectoral nerve block versus thoracic paravertebral block
		Total analgesic consumption (opioid consumption)	24 hours post-op
		VAS (10 cm; not stated)	0 hours post-op
			0.5 hours post-op
			1 hour post-op
			2 hours post-op
			4 hours post-op
			6 hours post-op
			8 hours post-op
			12 hours post-op
			24 hours post-op
Moura et al. [35]	Brazil	NRS (not stated; 0–10)	T0 (after recovering consciousness)	Femoral nerve block
			1 hour post-op
			2 hours post-op
		Total dose of supplementary analgesia (opioid and nonopioid)	First 2 hours
		Time to first analgesic supplementation
Nagafuchi et al. [34]	Japan	NRS (not stated; 0–10)	Exiting operating room	Femoral nerve block-sciatic nerve block versus femoral nerve block-LIA
			3 hours post-op
			12 hours post-op
			24 hours post-op
		Total dose of diclofenac
Salviz et al. [33]	USA	Time to first pain	Hours	Interscalene brachial plexus block
		Analgesic consumption (opioid)	D1 post-op
			D2 post-op
			D3 post-op
			D4 post-op
			D5 post-op
			D6 post-op
			D7 post-op
		Maximum NRS (not stated; 0–10)	D1 post-op
			D2 post-op
			D3 post-op
			D4 post-op
			D5 post-op
			D6 post-op
			D7 post-op
Sawhney et al. [32]	Canada	NRS on activity (0–10)	D1 post-op	Combined adductor canal block with periarticular infiltration versus adductor canal nerve block
		NRS at rest and with knee bending (0–10)	D1 post-op
		NRS on activity (0–10)	D2 post-op
		NRS at rest and with knee bending (0–10)	D2 post-op
		Analgesic consumption (opioid and nonopioid) per day
Sato et al. [31]	Japan	VAS (10 cm) at rest	At rest just after surgery	Sciatic and femoral continuous versus single shot
			6 hours after surgery
			AM D1 post-op
			PM D1 post-op
			AM D2 post-op
			PM D2 post-op
		Morphine consumption	Over first 48 hours
Siddiqui et al. [41]	USA	VAS (10 cm) at rest	Every 5 min first hour	Lumbar plexus block
			4 hours post-op
			8 hours post-op
			16 hours post-op
			20 hours post-op
			24 hours post-op
			28 hours post-op
			32 hours post-op
			36 hours post-op
Sindjelic et al. [30]	Serbia	Time to first analgesic request	Min	Cervical plexus block
		Total opioid consumption	24 hours post-op
Schoenmakers et al. [29]	Netherlands	Time to first analgesic request	Min	Popliteal continuous
		NRS at rest (0–10)	Immediately post-op
			24 hours
		NRS on activity (0–10)	Immediately post-op
			24 hours
Subramanyam et al. [28]	Canada	NRS (not stated; 0–10)	30 min post-op	Supraclavicular brachial plexus block
			60 min post-op
			90 min post-op
		Time to first analgesic request	Min
Stundner et al. [27]	Austria	NRS at rest (0–10)	Baseline before ISB	Interscalene brachial plexus block
			Immediately post-op
			6 hours post-op worst pain
			8 hours post-op worst pain
			10 hours post-op worst pain
			12 hours post-op worst pain
			14 hours post-op worst pain
			AM D1 post-op worst pain
		NRS on activity (0–10)	Baseline before ISB
			Immediately post-op
			6 hours post-op worst pain
			8 hours post-op worst pain
			10 hours post-op worst pain
			12 hours post-op worst pain
			14 hours post-op worst pain
			AM D1 post-op worst pain
Thybo et al. [26]	Denmark	VAS (10 cm) during 30° hip flexion	4 hours post-op (T4) at T0 (pts able to move toes but before SAB worn off)	Lateral cutaneous femoral nerve block
		Pain at rest VAS (10 cm) and during 30° hip flexion	T0
		Pain at rest VAS (10 cm) and during 30° hip flexion	T1 (after T0)
		Pain at rest VAS (10 cm) and during 30° hip flexion	T2 (after T0)
		Pain at rest VAS (10 cm) and during 30° hip flexion	T4 (after T0)
		Pain at rest VAS (10 cm) and during 30° hip flexion	T8 (after T0)
		Pain at rest VAS (10 cm) and during 30° hip flexion	T12 (after T0)
		Pain at rest VAS (10 cm) and during 30° hip flexion	T24 (after T0)
		Cumulative oxycodone consumption	0–24 hours post-op
Wegener et al. [25]	Netherlands	WOMAC score	At rest at 3 months	Sciatic nerve block
			On mobilising at 3 months
			At rest 12 months
			On mobilising at 12 months
		VAS (10 cm)	At rest 3 months
			On mobilising at 3 months
			At rest 12 months
			On mobilising at 12 months
		Oxford knee score (inc. pain)
Wegener et al. [24]	Netherlands	NRS at rest (0–10)	AM D1 post-op	Sciatic and femoral continuous versus single
			PM D1 post-op
			AM D2 post-op
			PM D2 post-op
			AM D3 post-op
			PM D3 post-op
		NRS on mobilisation (0–10)	AM D1 post-op
			PM D1 post-op
			AM D2 post-op
			PM D2 post-op
			AM D3 post-op
			PM D3 post-op
		Total morphine consumption	D0 post-op
			D1 post-op
			D2 post-op
			D3 post-op
Wongyingsinn et al. [23]	Canada	NRS at rest (0–10)	24 hours post-op	Thoracic epidural block
			48 hours post-op
			72 hours post-op
		NRS on walking (0–10)	24 hours post-op
			48 hours post-op
			72 hours post-op
		NRS on coughing (0–10)	24 hours post-op
			48 hours post-op
			72 hours post-op
YaDeau et al. [40]	USA	NRS at rest (0–10)	30 min post-op	Lumbar plexus block
			1 hour post-op
			2 hours post-op
			3 hour post-op
			4 hours post-op
			24 hours post-op
		NRS on movement (0–10)	30 min post-op
			1 hour post-op
			2 hours post-op
			3 hour post-op
			4 hours post-op
			24 hours post-op
Zhai et al. [22]	Not stated	NRS at rest (0–10)	Before block	Interscalene brachial plexus block
			Right before discharge from PACU
			4 hours after block
			8 hours after block
			24 hours after block
		Worst NRS (0–10)	24 hours after block
		Time of first shoulder pain

D0 post-op = Day 0 postoperatively; D1 post-op = Day 1 postoperatively; D2 post-op = Day 2 postoperatively; D3 post-op = Day 3 postoperatively; D4 post-op = Day 4 postoperatively; D5 post-op = Day 5 postoperatively; D6 post-op = Day 6 postoperatively; D7 post-op = Day 7 postoperatively; min = minutes; NRS = numeric (verbal) rating scale (0 = no pain to 10 = worst imaginable pain); VAS = visual analogue scale (0 mm = no pain to 100 mm = worst imaginable pain); APS-POQ-R = American Pain Society Patient Outcome Questionnaire Revised; WOMAC score = Western Ontario and McMaster Universities Osteoarthritis Index (5 pain questions included) OA specific; Oxford Knee Score 12-item knee questionnaire on pain; for measurement tool, “not stated” = whether pain score recorded at rest or on movement not stated in methods.