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Author Spotlight: Regenerative Peripheral Nerve Interface (RPNI) Surgery in Postamputation Pain Management
Published on: March 15, 2024
One half of patients reports persistent pain three months after orthopaedic surgery
Régis Fuzier1, Julien Rousset2, Benoît Bataille2
1Department of Anaesthesia, Institut Claudius Regaud, IUCT-O, 31059 Toulouse, France; INSERM 1027, Pharmacoepidemiology Research Unit, University of Toulouse, 31000 Toulouse, France.
Objective:
To determine persistent post-surgical pain prevalence after orthopaedic surgery with its impact on patient quality of life and to assess factors related to it.
Study Design:
Cross-sectional cohort study.
Patients:
A questionnaire was mailed to 2100 patients undergoing orthopaedic surgery in our teaching hospital.
Methods:
Pain prevalence 3 months after surgery, pain intensity, a neuropathic pain component using the DN4 questionnaire and its impact on patient quality of life were assessed.
Results:
One thousand two hundred and ninety-two patients answered our questionnaire. Among them, 48% suffered from chronic pain. This pain had a neuropathic component in 43%, which was responsible for analgesic overconsumption and increases in sleep disturbance and sick leave. Arthrodesis, knee arthroplasty and leg fracture were linked to increased chronic post-surgical pain (OR=2.7, OR=1.8, OR=1.9, respectively; P<0.05). Elbow surgery, meniscectomy, amputation and neurolysis were linked to increased neuropathic pain.
Conclusions:
Chronic, post-surgical pain is common after orthopaedic surgery, leading to analgesic consumption and sleep disturbance. Patients at high risk for developing chronic post-surgical pain must be identified preoperatively. The development of postoperative pain clinics should be one way to respond to this public health problem.
