Preventing the Transition from Acute to Chronic Musculoskeletal Pain in Adolescents after Surgery: The Role of Sleep

防止青少年手术后从急性肌肉骨骼疼痛转变为慢性肌肉骨骼疼痛：睡眠的作用

• 批准号: 10879417
• 负责人: Jennifer Rabbitts
• 金额: $ 17.97万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2028-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10879417
• 关键词: Acceleration; Acute; Acute Pain; Address; Adherence; Adolescence; Adolescent; Adult; Age; Anesthesiology; Anxiety; Applications Grants; Award; Childhood; Chronic; Clinical; Clinical Trials; Collaborations; Complementary therapies; Data; Dose; Enrollment; Enteral; Epidemic; Event; Fellowship; Funding; Generations; Health; Hormones; Intervention; Knowledge; Link; Longevity; Mediating; Mediator; Medicine; Melatonin; Mentors; Mentorship; Methodology; Methods; Mid-Career Clinical Scientist Award (K24); Midcareer Investigator Award in Patient-Oriented Research; Modeling; Monitor; Musculoskeletal; Musculoskeletal Pain; National Institute of Arthritis, and Musculoskeletal, and Skin Diseases; Needles; Operative Surgical Procedures; Outcome; Pain; Pain Research; Pain intensity; Pain interference; Parents; Pathway interactions; Perioperative; Persistent pain; Physicians; Population; Postdoctoral Fellow; Postoperative Pain; Postoperative Period; Prevention; Psychophysics; Public Health; Reporting; Research; Research Personnel; Research Project Grants; Research Support; Risk; Risk Factors; Risk Marker; Role; Safety; Science; Scientist; Sleep; Sleep Wake Cycle; Sleep disturbances; Spinal Fusion; Spine surgery; Teenagers; Testing; Time; Training; Training Programs; Universities; Washington; Youth; acceptability and feasibility; biopsychosocial; career; chronic musculoskeletal pain; chronic pain; clinical pain; cohort; effectiveness evaluation; efficacy testing; efficacy trial; experience; feasibility trial; fibromyalgia patients; follow-up; forging; health goals; health related quality of life; high risk; improved; improvement on sleep; innovation; longitudinal design; mHealth; mid-career faculty; minimal risk; modifiable risk; next generation; non-opioid analgesic; novel; pain chronification; pain processing; pain reduction; pain sensitivity; patient oriented; pilot trial; poor health outcome; prevent; preventive intervention; primary outcome; programs; psychosocial; research study; resilience; resilience factor; secondary outcome; sensory mechanism; sex; side effect; skills; sleep quality; sleep regulation; training opportunity; Acceleration; Acute; Acute Pain; Address; Adherence; Adolescence; Adolescent; Adult; Age; Anesthesiology; Anxiety; Applications Grants; Award; Childhood; Chronic; Clinical; Clinical Trials; Collaborations; Complementary therapies; Data; Dose; Enrollment; Enteral; Epidemic; Event; Fellowship; Funding; Generations; Health; Hormones; Intervention; Knowledge; Link; Longevity; Mediating; Mediator; Medicine; Melatonin; Mentors; Mentorship; Methodology; Methods; Mid-Career Clinical Scientist Award (K24); Midcareer Investigator Award in Patient-Oriented Research; Modeling; Monitor; Musculoskeletal; Musculoskeletal Pain; National Institute of Arthritis, and Musculoskeletal, and Skin Diseases; Needles; Operative Surgical Procedures; Outcome; Pain; Pain Research; Pain intensity; Pain interference; Parents; Pathway interactions; Perioperative; Persistent pain; Physicians; Population; Postdoctoral Fellow; Postoperative Pain; Postoperative Period; Prevention; Psychophysics; Public Health; Reporting; Research; Research Personnel; Research Project Grants; Research Support; Risk; Risk Factors; Risk Marker; Role; Safety; Science; Scientist; Sleep; Sleep Wake Cycle; Sleep disturbances; Spinal Fusion; Spine surgery; Teenagers; Testing; Time; Training; Training Programs; Universities; Washington; Youth; acceptability and feasibility; biopsychosocial; career; chronic musculoskeletal pain; chronic pain; clinical pain; cohort; effectiveness evaluation; efficacy testing; efficacy trial; experience; feasibility trial; fibromyalgia patients; follow-up; forging; health goals; health related quality of life; high risk; improved; improvement on sleep; innovation; longitudinal design; mHealth; mid-career faculty; minimal risk; modifiable risk; next generation; non-opioid analgesic; novel; pain chronification; pain processing; pain reduction; pain sensitivity; patient oriented; pilot trial; poor health outcome; prevent; preventive intervention; primary outcome; programs; psychosocial; research study; resilience; resilience factor; secondary outcome; sensory mechanism; sex; side effect; skills; sleep quality; sleep regulation; training opportunity

PROJECT SUMMARY Acute and chronic musculoskeletal (MSK) pain are important health concerns across the lifespan, and surgery is a chief inciting event for subsequent persistent pain. Eighty percent of adolescents undergoing major MSK surgery report severe acute pain, and 20% develop chronic postsurgical pain. Having chronic pain in childhood and adolescence increases risk for a continued negative trajectory of MSK pain and poor health outcomes in adulthood, contributing to the national pain crisis. This K24 award will provide critical support for Dr. Rabbitts, a NIAMS-supported Associate Professor of Anesthesiology and Pain Medicine at the University of Washington (UW). The candidate's programmatic research has focused on developing innovative methods to identify biopsychosocial contributors to acute and chronic pain following MSK surgery in adolescents. During the course of this award, she will complete currently supported research: R01AR073780 which aims to increase understanding of the transition from acute to chronic postsurgical pain and the causal mechanisms involved, and UH3HD102038 (HEAL clinical trial) which evaluates the effectiveness of an mHealth perioperative psychosocial intervention to reduce acute and chronic pain in adolescents undergoing major musculoskeletal surgery. The candidate will expand her interprofessional mentoring program to build a strong and diverse cohort of pain scientists equipped to develop and implement long-term solutions to the MSK pain crisis through prevention. This K24 will also allow extension of the candidate's perioperative research program through training in sleep methodologies and building new collaborations to forge a novel research direction focused on sleep. The specific aims of the two new research studies proposed are to: 1) test pain processing as a mediator in the relationship between adolescent sleep immediately following surgery and subsequent MSK pain at 2 months after spine surgery, and 2) to determine feasibility of peri-operative melatonin in youth undergoing MSK surgery. The four projects will provide mentees with rigorous methodological training in a broad range of pain research assessment and intervention methods. This will capitalize on the wealth of opportunities available at SCRI and UW to actively engage promising trainees in the candidate's role as a physician-scientist, including via the SCRI Pediatric Pain Research Postdoctoral Fellowship and the UW T32 Training Program in Anesthesiology and Perioperative Medicine Research. Release from clinical activities provided by this award will allow the candidate to expand mentees at the fellow level, while enhancing mentorship skills, to equip a new generation of pain researchers with necessary scientific and professional skills, resiliency, and commitment to pain science, to make a sustained impact on the pain crisis. The K24 will also accelerate the candidate's research momentum informing the Type II renewal of her R01 and a new U01 efficacy trial of perioperative melatonin, which will be critical to her career objectives to achieve a deep understanding of contributing mechanisms and intervening to prevent acute to chronic MSK pain transition.

项目摘要 急性和慢性肌肉骨骼（MSK）疼痛是整个生命周期的重要健康问题，手术 是煽动随后持续疼痛的主要煽动性事件。百分之八十的青少年正在接受主要MSK 手术报告严重的急性疼痛，20％会出现慢性术后疼痛。童年时期慢性疼痛 青春期增加了MSK疼痛持续负面轨迹和健康状况不佳的风险 成年，导致国家疼痛危机。该K24奖将为Rabbitts博士提供关键支持， NIAMS支持的华盛顿大学麻醉与疼痛医学副教授 （UW）。候选人的程序化研究重点是开发创新方法来识别 青少年MSK手术后，急性和慢性疼痛的生物心理社会贡献者。在 该奖项的课程，她将完成目前支持的研究：R01AR073780，旨在增加 了解从急性到慢性术后疼痛和涉及的因果机制的过渡， 和UH3HD102038（治愈临床试验），评估了MHealth围手术期的有效性 心理心理干预以减轻患有主要肌肉骨骼的青少年急性和慢性疼痛 外科手术。候选人将扩大她的跨专业指导计划，以建立强大而多样的 一系列疼痛科学家，能够通过 预防。该K24还将允许通过 睡眠方法和建立新的合作培训，以建立一个专注于的新型研究方向 睡觉。提出的两项新研究的具体目的是：1）测试疼痛处理作为一种 在手术后立即与青少年睡眠与随后的MSK之间的关系中的调解人 脊柱手术后2个月的疼痛和2）确定围手术期褪黑激素在青年中的可行性 接受MSK手术。这四个项目将为受训者提供严格的方法论培训 广泛的疼痛研究评估和干预方法。这将利用 SCRI和UW上可用的机会积极吸引有前途的学员担任候选人的角色 医师科学家，包括通过SCRI小儿疼痛研究博士后研究金和UW T32 麻醉和围手术医学研究的培训计划。从临床活动中释放 该奖项提供的将使候选人能够在同胞增强同时扩大受训者 指导技巧，为新一代疼痛研究人员配备必要的科学和专业 对疼痛科学的技能，韧性和承诺，对疼痛危机产生持续影响。 K24会 还加速了候选人的研究势头，以告知其R01的II型续订和新的U01 围手术期褪黑激素的功效试验对她的职业目标至关重要 了解促进机制和干预以防止急性慢性MSK疼痛转变。