{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:09:33Z","timestamp":1790168973593,"version":"4.1.0"},"reference-count":25,"publisher":"Walter de Gruyter GmbH","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_sjpain-2020-0141_s_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>In this sub-study of the \u2018Paracetamol and Ibuprofen in Combination\u2019 (PANSAID) trial, in which participants were randomised to one of four different non-opioids analgesic regimen consisting of paracetamol, ibuprofen, or a combination of the two after planned primary total hip arthroplasty, our aims were to investigate the distribution of participants\u2019 pain (mild, moderate or severe), integrate opioid use and pain to a single score (Silverman Integrated Approach (SIA)-score), and identify preoperative risk factors for severe pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2020-0141_s_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We calculated the proportions of participants with mild (VAS 0\u201330\u00a0mm), moderate (VAS 31\u201360\u00a0mm) or severe (VAS 61\u2013100\u00a0mm) pain and the SIA-scores (a sum of rank-based percentage differences from the mean rank in pain scores and opioid use, ranging from\u00a0\u2212200 to 200%). Using logistic regression with backwards elimination, we investigated the association between severe pain and easily obtainable preoperative patient characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2020-0141_s_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 556 participants from the modified intention-to-treat population, 33% (95% CI: 26\u201342) (Group Paracetamol\u00a0+\u00a0Ibuprofen (PCM\u00a0+\u00a0IBU)), 28% (95% CI: 21\u201337) (Group Paracetamol (PCM)), 23% (95% CI: 17\u201331) (Group Ibuprofen (IBU)), and 19% (95% CI: 13\u201327) (Group Half Strength-Paracetamol\u00a0+\u00a0Ibuprofen (HS-PCM\u00a0+\u00a0IBU)) experienced mild pain 6\u00a0h postoperatively during mobilisation. Median SIA-scores during mobilisation were: Group PCM\u00a0+\u00a0IBU:\u00a0\u221248% (IQR:\u00a0\u2212112 to 31), Group PCM: 40% (IQR:\u00a0\u221231 to 97), Group IBU:\u00a0\u22125% (IQR:\u00a0\u221257 to 67), and Group HS-PCM\u00a0+\u00a0IBU: 6% (IQR:\u00a0\u221270 to 74) (overall difference: p=0.0001). Use of analgesics before surgery was the only covariate associated with severe pain (non-opioid: OR 0.50, 95% CI: 0.29\u20130.82, weak opioid 0.56, 95% CI: 0.28\u20131.16, reference no analgesics before surgery, p=0.02).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2020-0141_s_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Only one third of participants using paracetamol and ibuprofen experienced mild pain after total hip arthroplasty and even fewer experienced mild pain using each drug alone as basic non-opioid analgesic treatment. We were not able, in any clinically relevant way, to predict severe postoperative pain. A more extensive postoperative pain regimen than paracetamol, ibuprofen and opioids may be needed for a large proportion of patients having total hip arthroplasty. SIA-scores integrate pain scores and opioid use for the individual patient and may add valuable information in acute pain research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/sjpain-2020-0141","type":"journal-article","created":{"date-parts":[[2021,1,10]],"date-time":"2021-01-10T21:37:16Z","timestamp":1610314636000},"page":"384-392","source":"Crossref","is-referenced-by-count":5,"title":["Participants with mild, moderate, or severe pain following total hip arthroplasty. A sub-study of the PANSAID trial on paracetamol and ibuprofen for postoperative pain treatment"],"prefix":"10.1515","volume":"21","author":[{"given":"Luma Mahmoud","family":"Issa","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Centre for Anaesthesiological Research , Zealand University Hospital , K\u00f8ge , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasper H\u00f8jgaard","family":"Thybo","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Centre for Anaesthesiological Research , Zealand University Hospital , K\u00f8ge , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"H\u00e4gi-Pedersen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Head of Research , N\u00e6stved, Slagelse and Ringsted Hospitals , N\u00e6stved , Denmark"},{"name":"Department of Regional Health Research , University of Southern Denmark , Odense , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f8rn","family":"Wetterslev","sequence":"additional","affiliation":[{"name":"Copenhagen Trial\u00a0Unit, Rigshospitalet , Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janus Christian","family":"Jakobsen","sequence":"additional","affiliation":[{"name":"Department of Regional Health Research , University of Southern Denmark , Odense , Denmark"},{"name":"Copenhagen Trial\u00a0Unit, Rigshospitalet , Copenhagen , Denmark"},{"name":"Department of Cardiology , Holb\u00e6k Hospital , Holb\u00e6k , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren","family":"Overgaard","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Traumatology, Orthopaedic Research Unit , Odense University Hospital , Odense , Denmark"},{"name":"Department of Clinical Research , University of Southern Denmark , Odense , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ole","family":"Mathiesen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Centre for Anaesthesiological Research , Zealand University Hospital , K\u00f8ge , Denmark"},{"name":"Department of Clinical Medicine , University of Copenhagen , Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2021,1,6]]},"reference":[{"key":"2025120910045529405_j_sjpain-2020-0141_ref_001","doi-asserted-by":"crossref","unstructured":"Sommer, M, de Rijke, JM, van Kleef, M, Kessels, AG, Peters, ML, Geurts, JW, et al.. 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