Johnson et al reported the Postoperative Analgesic Intake Needs (PAIN) Score. This can help to identify a patient with high analgesic requirements prior to surgery. The authors are from the University of Texas Southwestern Medical Center and Northwestern University.
Patient selection: prior to spinal surgery
Outcome: need for > 100 MME per day status post surgery
Parameters:
(1) age in years
(2) race
(3) history of depression and/or anxiety
(4) active preoperative benzodiazepine use
(5) active preoperative opioid use
(6) smoking history
(7) surgical category
Parameter
Finding
Points
age in years
<= 44 years
8
45 to 64 yeara
3
>= 65 years
0
race
white/Caucasian
2
other
0
depression or anxiety
no
0
yes
1
benzodiazepine use
no
0
yes
1
opioid use
no
0
schedule II narcotic
4
schedule III or IV narcotic
2
smoking history
current
3
never or former
0
surgical category
lumbar, long segment
3
lumber, short segment
1
posterior cervical or thoracic
1
anterior cervical
0
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 22
Total Score
Risk of High Opioid Consumption After Surgery
Percent High Opioid Requirements
<= 5
low
51%
6 to 10
moderate
28%
>= 11
high
6%
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