AAAPT Diagnostic Criteria for Acute Abdominal and Peritoneal Pain After Surgery

Mark C Bicket; Michael C Grant; Michael J Scott; Gregory W Terman; Elizabeth C Wick; Christopher L Wu

doi:10.1016/j.jpain.2020.01.004

AAAPT Diagnostic Criteria for Acute Abdominal and Peritoneal Pain After Surgery

J Pain. 2020 Nov-Dec;21(11-12):1125-1137. doi: 10.1016/j.jpain.2020.01.004. Epub 2020 Jan 30.

Authors

Mark C Bicket¹, Michael C Grant², Michael J Scott³, Gregory W Terman⁴, Elizabeth C Wick⁵, Christopher L Wu⁶

Affiliations

¹ Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: bicket@jhmi.edu.
² Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
³ Department of Anesthesiology, Virginia Commonwealth University; Richmond, Virginia.
⁴ Department of Anesthesiology, University of Washington, Seattle, Washington.
⁵ Department of Surgery; The University of California San Francisco, San Francisco, California.
⁶ Department of Anesthesiology, Critical Care & Pain Management; Hospital for Special Surgery, New York, New York; Department of Anesthesiology, Weill Cornell Medicine, New York, New York.

PMID: 32006701
DOI: 10.1016/j.jpain.2020.01.004

Abstract

Abdominal and peritoneal pain after surgery is common and burdensome, yet the lack of standardized diagnostic criteria for this type of acute pain impedes basic, translational, and clinical investigations. The collaborative effort among the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks, American Pain Society, and American Academy of Pain Medicine Pain Taxonomy (AAAPT) provides a systematic framework to classify acute painful conditions. Using this framework, a multidisciplinary working group reviewed the literature and developed core diagnostic criteria for acute abdominal and peritoneal pain after surgery. In this report, we apply the proposed AAAPT framework to 4 prototypical surgical procedures resulting in abdominal and peritoneal pain as examples: cesarean delivery, cholecystectomy, colorectal surgical procedures, and pancreas resection. These diagnostic criteria address the 3 most common surgical procedures performed in the United States, capture diverse surgical approaches, and may also be applied to other surgical procedures resulting in abdominal and peritoneal pain. Additional investigation regarding the validity and reliability of this framework will facilitate its adoption in research that advances our comprehension of mechanisms, deliver better treatments, and help prevent the transition of acute to chronic pain after surgery in the abdominal and peritoneal region. PERSPECTIVE: Using AAAPT, we present key diagnostic criteria for acute abdominal and peritoneal pain after surgery. We provide a systematic classification using 5 dimensions for abdominal and peritoneal pain that occurs after surgery, in addition to 4 specific surgical procedures: cesarean delivery, cholecystectomy, colorectal surgical procedures, and pancreas resection.

Keywords: Abdominal and peritoneal pain; cesarean delivery; cholecystectomy; colorectal surgery; surgical or postsurgical or postoperative pain.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Abdominal Pain / classification
Abdominal Pain / diagnosis*
Abdominal Pain / etiology
Acute Pain / classification
Acute Pain / diagnosis*
Acute Pain / etiology
Congresses as Topic / standards
Consensus
Female
Humans
Male
Pain Measurement / methods*
Pain Measurement / standards
Pain, Postoperative / classification
Pain, Postoperative / diagnosis*
Pain, Postoperative / etiology
Peritoneum / pathology*
Public-Private Sector Partnerships / standards
Societies, Medical* / standards
United States