Gerontological Nursing Interventions Research Center (GNIRC)

Title: Hyperalgesia Measurement in Post-Surgical Elders
Principal Investigator: Barbara Rakel, PhD, RN
Study Site: The University of Iowa

Abstract
The proposed feasibility study is the first phase of a three-phase trajectory to investigate the effects of non-pharmacologic interventions on hyperalgesia, pain with movement, and persistent pain after surgery. Hyperalgesia, a decrease in pain threshold and increase in pain to suprathreshold stimuli, has not been tested in elderly post-surgical patients and there are no data on the feasibility of this assessment in older adult patients experienceing pain. Specific aims are to determine: 1) if routine secondary hyperalgesia assessments can be tolerated by elderly patients during preoperative and immediate postoperative periods and if assessments that are tolerated provide sensitive data for evaluating changes; and 2) if elderly patients undergoing elective hip replacement surgery are an appropriate population for assessing secondary hyperalgesia and determining the effect of hyperalgesia on pain with movement. A two-part, descriptive, correlational design will be used. The outcomes of this feasibility study will provide direction for a phase II descriptive, correlational study evaluating the presence and characteristics of secondary hyperalgesia and the relationship between the area and threshold of secondary hyperalgesia and both pain with movement and persistent pain in elderly hip replacement patients. It is expected that this information will ultimately support one or more intervention studies evaluating the effectiveness of non-pharmacologic interventions on the area and threshold of secondary hyperalgesia and evaluate how these effects correlate with movement-evoked pain and persistent pain ratings in older adults after surgery.