Assessment of pain intensity using summed pain intensity difference (SPID) in orthopedic operative patients

TL;DR

This study evaluates the SPID scale for measuring postoperative pain in orthopedic patients, showing it correlates with recovery and satisfaction.

Contribution

Validates SPID as a time-adjusted pain assessment tool in orthopedic surgery for the first time.

Findings

Mean SPID was 72, indicating moderate pain relief in orthopedic patients.

SPID correlated with patient satisfaction and shorter hospitalization duration.

NSAIDs and opioids improved SPID by 50%.

Abstract

Effective postoperative pain management in orthopaedics is challenging, with conventional tools lacking time-adjusted assessment. The Summed Pain Intensity Difference (SPID) scale, quantifying cumulative pain reduction, requires clinical validation.

This study assessed SPID's utility in evaluating postoperative pain management efficacy, correlating it with patient outcomes, analgesic use, and recovery. Primary outcomes included 48-hour SPID scores; secondary outcomes were satisfaction, analgesics, and hospitalization duration.

A prospective observational study included 148 orthopaedic patients over six months. Sociodemographic, surgical, and analgesic data were collected. Pain intensity (Numerical Rating Scale, NRS) was measured preoperatively and at 0–48 hours postoperatively. SPID (maximum: 144) was calculated as cumulative NRS differences from baseline, adjusted for time. Statistical analyses included descriptive/inferential tests (p<0.05).

Mean SPID was 72 (50% of maximum), indicating moderate pain relief. Spinal/epidural anesthesia (44.4%/31.9%) reduced postoperative NRS (moderate: 6.84±0.36; severe:8.44±0.76) versus general anesthesia. Comorbidities (hypertension/diabetes) correlated with higher baseline pain (NRS:8.44±0.76). NSAIDs/opioids improved SPID by 50%. Hospitalization averaged 6.5 days, shorter with SPID≥50% (p<0.05). Overall satisfaction was 67.5%, correlating with SPID (r=0.45,p<0.01).

SPID demonstrated validity as a time-adjusted tool, aligning with patient satisfaction and recovery metrics. Its integration can standardize pain assessment in orthopaedic care, particularly in resource-limited settings.

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