Gender aspects in postoperative pain

Gender differences are well known in clinical pain and pain-related diseases. However, studies analyzing gender differences in postoperative pain yielded inconsistent finding. The aim of this review was to summarize recent findings on this matter.

We found 58 recently published studies (September 2013-March 2015) assessing gender differences on patients undergoing various surgical procedures. Studies focusing on one type or one category of surgical procedures suggest that women report higher postoperative pain scores after thoracic, cardiac and neurosurgical procedures. However, gender differences after abdominal and orthopedic surgeries were inconsistent and after oral surgery inexistent. Studies including various surgical procedures indicate a more consistent gender difference, presumably because of the greater number of patients included. However, the net difference in almost every study was small.

Women seem to be at higher risk to develop severe postoperative pain but gender differences seem to be small and of low clinical relevance. We argue that major confounders may explain discrepancies between studies. Large prospective studies and registry data assessing gender aspects including confounders need to be done in the future.