title: The cumulative analgesic consumption score (CACS): evaluation of a new score to describe postsurgical analgesic consumption as a surrogate parameter for postoperative pain and invasiveness of surgical procedures.
abstract: OBJECTIVE
  To validate and evaluate the applicability of a new score to describe postsurgical analgesic consumption in urological and surgical patients across different categories of pain medications and the invasiveness of medical interventions.
  
  
  METHODS
  The cumulative analgesic consumption score (CACS) was determined for two cohorts of patients split into three groups with surgeries involving clinically distinct levels of invasiveness (n = 2 x 60). Nonparametric statistical analyses were performed to determine differences between the CACS among the different groups and to assess the correlation between CACS and numeric rating scale (NRS) values for pain intensity.
  
  
  RESULTS
  The score was determined for postoperative days 1 and 2 and revealed median scores of 0 (0-11), 3 (0-22) and 10 (6-17) for UA (urological patients from group A), UB (group B) and UC (group C), respectively, and 4 (0-20), 8 (0-38) and 17 (7-68) for SA (surgical patients from group A, SB (group B) and SC (group C), respectively. CACS enabled reliable differentiation between groups involving different levels of invasiveness (p < 0.001). CACS and peak NRS values showed variable degrees of correlation, as expressed by levels of significance ranging from p < 0.001 to p = 0.34 (NS).
  
  
  CONCLUSIONS
  The CACS is a valid and easily applicable tool to describe postsurgical analgesic consumption in urological and surgical patients. It can be used as a surrogate parameter to assess postsurgical pain and the invasiveness of surgical procedures. These aspects may be measured to compare surgical procedures, in both clinical trials and clinical practice settings.
authors.affiliation: Department of Urology, , University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Schoenthaler
authors.affiliation: 1Department of Urology, , University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Miernik
authors.affiliation: Department of Anesthesiology, , University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Offner
authors.affiliation: Department of General and Visceral Surgery, , University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Wojciech Konrad
authors.initials: WK
authors.lastname: Karcz
authors.affiliation: Institute of Medical Biometry and Medical Informatics, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Hauschke
authors.affiliation: Department of Urology, Medical University of Vienna, Vienna, Austria.
authors.forename: Sabina
authors.initials: S
authors.lastname: Sevcenco
authors.affiliation: Department of Urology, Medical University of Vienna, Vienna, Austria.
authors.forename: Franklin Emmanuel
authors.initials: FE
authors.lastname: Kuehhas
authors.affiliation: Department of Urology, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom.
authors.forename: Christian
authors.initials: C
authors.lastname: Bach
authors.affiliation: Department of Urology, The Royal London Hospital, Bartshealth NHS Trust, London, United Kingdom.
authors.forename: Noor
authors.initials: N
authors.lastname: Buchholz
authors.affiliation: Department of Urology, , University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Konrad
authors.initials: K
authors.lastname: Wilhelm
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy*; D012016:Reference Values; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D013520:Urologic Surgical Procedures / Q000009:adverse effects*
chemical_list: D000700:Analgesics