Assessment of pain intensity using summed pain intensity difference (SPID) in orthopedic operative patients

Background: Effective postoperative pain management in orthopaedics is challenging, with conventional tools lacking time-adjusted assessment. The Summed Pain Intensity Difference (SPID) scale, quantifying cumulative pain reduction, requires clinical validation. Objectives: This study assessed SPID's utility in evaluating postoperative pain management efficacy, correlating it with patient outcomes, analgesic use, and recovery. Primary outcomes included 48-hour SPID scores; secondary outcomes were satisfaction, analgesics, and hospitalization duration. Methods: A prospective observational study included 148 orthopaedic patients over six months. Sociodemographic, surgical, and analgesic data were collected. Pain intensity (Numerical Rating Scale, NRS) was measured preoperatively and at 0-48 hours postoperatively. SPID (maximum: 144) was calculated as cumulative NRS differences from baseline, adjusted for time. Statistical analyses included descriptive/inferential tests (p<0.05). Results: Mean SPID was 72 (50% of maximum), indicating moderate pain relief. Spinal/epidural anesthesia (44.4%/31.9%) reduced postoperative NRS (moderate: 6.84±0.36; severe:8.44±0.76) versus general anesthesia. Comorbidities (hypertension/diabetes) correlated with higher baseline pain (NRS:8.44±0.76). NSAIDs/opioids improved SPID by 50%. Hospitalization averaged 6.5 days, shorter with SPID≥50% (p<0.05). Overall satisfaction was 67.5%, correlating with SPID (r=0.45,p<0.01). Conclusions: SPID demonstrated validity as a time-adjusted tool, aligning with patient satisfaction and recovery metrics. Its integration can standardize pain assessment in orthopaedic care, particularly in resource-limited settings.

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