Chronic postsurgical pain in mixed surgical population. Does an acute pain service make a difference?

To investigate the influence of an Acute Pain Service (APS) on the incidence of chronic postsurgical pain (CPSP). To assess the acute pain intensity as a risk factor for CPSP. The impact of an APS on the incidence of CPSP has not yet been studied.

Retrospective questionnaire given to randomized cohorts study, performed in two hospitals - Hospital A with an APS and Hospital B without such service. 1444 patients underwent eight different surgical procedures in both hospitals within one year, 175 patients from each hospital were randomized.

208 questionnaires were analysed. There was a significant difference in acute pain intensity in the first 24 hours after surgery. The difference of CPSP incidence between hospitals was not significant (Hospital A nine patients (8.6 %), Hospital B sixteen patients (15.5 %). The patients with CPSP experienced significantly more intensive pain in the first 24 hours and at discharge than patients without CPSP regardless of the hospital.

The study did not demonstrate the incidence of CPSP was lower in the hospital with an APS despite the lower postoperative pain scores. However there was a noticeable trend toward higher incidence of CPSP in the hospital without an APS. The study demonstrated that APS decreases intensity of an acute postoperative pain and acute pain intensity is a risk factor for CPSP incidence (Tab. 5, Ref. 27).