# Personalizing Perioperative Preventive Analgesia: Translational Studies Investigating the Biopsychosocial Underpinnings of Enhanced Pain Propensity

> **NIH NIH R35** · BRIGHAM AND WOMEN'S HOSPITAL · 2024 · $519,100

## Abstract

PROJECT SUMMARY
 Over 230 million people undergo surgery annually. The experience of postsurgical pain varies among
individuals, but a significant proportion (20-30%) of patients experience surgical site pain lasting at least a year
postoperatively. Such Persistent Post-Surgical Pain (PPSP) causes physical and mental suffering and
disability and lengthens exposure to opioid analgesics, potentially placing patients at risk of addiction. Despite
excellent research in basic research indicating potential mechanisms involved in the transition of acute to
chronic pain, little success at translating these findings to actual prevention of persistent postoperative pain in
human patients has been realized. My research program has developed a working human model of this
transition, by systematic and longitudinal studying pain before, during and after a variety of surgeries. We have
identified several patient-level risk factors that predict who is high-risk for developing PPSP, allowing more
efficient study of this problem, as well as insight into relevant mechanisms, in humans.
 A crucially important factor in determining the trajectory of PPSP appears to be the tendency for the
pain signal to be amplified. While pain amplification may be protective in the short term, it becomes
dysfunctional if excessive or persistent. In our psychophysics lab, we study measures that indicate excessive
amplification response of the nervous system in some individuals in response to standardized pain testing. We
also measure psychosocial factors such as stress, sleep disruption, and catastrophizing (a mental process by
which rumination, magnification, and worry increase salience and importance), which can also amplify the pain
signal. Importantly, pain amplification is more prominent in some individuals, and accounts for a sizeable
amount of the variation in pain resulting from surgery (and far more than the surgical extent). We have
developed a system to easily and non-invasively test this “amplification phenotype” in individuals BEFORE
surgery, using modified bedside quantitative sensory tests, and brief, validated psychosocial questionnaires.
 My research program has optimized measurement of our patients’ preoperative amplification
phenotype, to help target both known and novel non-opioid preventive treatments to these high-risk individuals.
Our goals for the next 5 years of this R35 award are: (1) to efficiently target the prevention of persistent pain
and opioid use after surgery in high-risk individuals, (2) to understand and target the underlying mechanisms
contributing to the development of PPSP, including understanding how pain amplification relates to the
inflammatory response to surgery, (3) to more widely apply preventive strategies, understanding their
differential efficacy among diverse samples of patients. As an Anesthesiologist with formal training in pain
neuroscience, psychophysical and psychosocial assessments, and practical experience in conducting
transl...

## Key facts

- **NIH application ID:** 10892778
- **Project number:** 5R35GM128691-07
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** KRISTIN SCHREIBER
- **Activity code:** R35 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $519,100
- **Award type:** 5
- **Project period:** 2018-09-01 → 2028-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10892778

## Citation

> US National Institutes of Health, RePORTER application 10892778, Personalizing Perioperative Preventive Analgesia: Translational Studies Investigating the Biopsychosocial Underpinnings of Enhanced Pain Propensity (5R35GM128691-07). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10892778. Licensed CC0.

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