OR19 - Predicting Acute Post-Surgical Pain Resolution Trajectories After Root End Resection Surgery

Abstract:
This prospective cohort study aimed to determine the predictors for resolving acute post-surgical pain trajectory (RPT) after root end resection surgery. Pre-operative data on demographics, medical and dental history, and clinical and psychosocial factors were collected from 93 subjects. Pain levels were assessed using a numerical rating scale pre-, intra-, and post-operatively during the 7-day period and at 1-month post-surgery. A latent mixed-effects model was utilized to classify pain trajectories based on the worst pain during the 7-day post-operative follow-up into either resolving or non-resolving groups. Univariate analysis was performed using Fisher’s exact or Wilcoxon signed-rank tests. The final multivariate logistic regression model was determined based on Akaike Information Criterion values and upon assessing collinearity. The latent class mixed-effects model revealed 79 subjects had RPT while 14 subjects had non-RPT. Univariate analysis revealed that the presence of any chronic pain and pre-operative pain associated with the surgical tooth, the duration of the surgery, Qualitative Somatosensory Testing, and the Pain Catastrophizing Scale (PCS) were associated with the resolution of associated-surgical pain (p = 0.1). The final regression model demonstrated that PCS score and the presence of pre-operative pain, intraoperative pain, and other chronic pain were positive predictors for the resolution of acute post-surgical pain after apicoectomy, while the use of long-lasting anesthesia emerged as a negative predictor (p = 0.1). This study underscores the key determinants influencing acute post-surgical pain resolution following apicoectomy, offering valuable insights for clinical management and treatment of post-surgical pain.