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Impact of movement-evoked pain on postoperative functional recovery
 The pathogenesis of postoperative lung dysfunction implies a role for movement-evoked pain (e.g. splinting/hypoventilation due to "pain avoidance"). In order to characterize the relationship between spontaneous versus movement-evoked pain and postoperative pulmonary dysfunction, we conducted a prospective observational study which showed that movement-evoked pain is more closely correlated with pulmonary dysfunction than is spontaneous (i.e. "pain at rest") pain (Gilron, Tod et. al., 2002). This would suggest that more effective treatment of movement-evoked pain may better address the adverse physiological changes seen following surgery.
Longstanding evidence that opioids preferentially reduce spontaneous pain together with our previous observation that the AMPA/kainate antagonist, LY293558, selectively reduces evoked pain (Gilron, Max et. al., 2000) suggests that these two phenomena may respond to distinct pharmacological targets. In our recent (Gilron, Orr et. al. 2005) and ongoing postoperative analgesic trials, we concurrently evaluate pain at rest and evoked by movement (e.g. sitting and coughing) in order to further characterize the differential effects of study drugs on these diverse pain experiences.
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Impact of movement-evoked pain on postoperative functional recovery