The Prediction of Acute Postoperative Pain Based on Neural Oscillations Measured before the Surgery

Qi Han, Lupeng Yue, Fei Gao, Libo Zhang, Li Hu, Yi Feng, Qi Han, Lupeng Yue, Fei Gao, Libo Zhang, Li Hu, Yi Feng

Abstract

Even with an improved understanding of pain mechanisms and advances in perioperative pain management, inadequately controlled postoperative pain remains. Predicting acute postoperative pain based on presurgery physiological measures could provide valuable insights into individualized, effective analgesic strategies, thus helping improve the analgesic efficacy. Considering the strong correlation between pain perception and neural oscillations, we hypothesize that acute postoperative pain could be predicted by neural oscillations measured shortly before the surgery. Here, we explored the relationship between neural oscillations 2 hours before the thoracoscopic surgery and the subjective intensity of acute postoperative pain. The spectral power density of resting-state beta and gamma band oscillations at the frontocentral region was significantly different between patients with different levels of acute postoperative pain (i.e., low pain vs. moderate/high pain). A positive correlation was also observed between the spectral power density of resting-state beta and gamma band oscillations and subjective reports of postoperative pain. Then, we predicted the level of acute postoperative pain based on features of neural oscillations using machine learning techniques, which achieved a prediction accuracy of 92.54% and a correlation coefficient between the real pain intensities and the predicted pain intensities of 0.84. Altogether, the prediction of acute postoperative pain based on neural oscillations measured before the surgery is feasible and could meet the clinical needs in the future for better control of postoperative pain and other unwanted negative effects. The study was registered on the Clinical Trial Registry (https://ichgcp.net/clinical-trials-registry/NCT03761576?term=NCT03761576&draw=2&rank=1) with the registration number NCT03761576.

Conflict of interest statement

All authors declare no competing interests.

Copyright © 2021 Qi Han et al.

Figures

Figure 1
Figure 1
(a) Study design and the (b) flow of participants.
Figure 2
Figure 2
The difference of spectral power density of resting-state neural oscillations between patients with different levels of acute postoperative pain, i.e., moderate/high pain and low pain.
Figure 3
Figure 3
The relationship between postoperative pain and resting-state EEG powers at beta (14-30 Hz) and gamma (31-50 Hz) frequency bands. Left: partial correlation was performed after controlling age and removing outliers. Right: independent-sample t-tests were performed between patients with different levels of acute postoperative pain, i.e., moderate/high pain and low pain.
Figure 4
Figure 4
The contribution of presurgery EEG features on the performance of classification and regression to predict the intensity of postoperative pain ((a, b) in the frequency domain; (c, d) in the spatial domain).
Figure 5
Figure 5
The correlation between subjective ratings of postoperative pain and the predicted ratings of postoperative pain by multiple linear regression with LOOCV.

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