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Chronic postsurgical pain: A European survey.

Valeria Martinez1, Thomas Lehman, Patricia Lavand'homme

  • 1From the Anaesthesia and Intensive Care Department, Raymond Poincaré Hospital, APHP, Garches, France; Université Paris-Saclay, UVSQ, Inserm, LPPD, Boulogne, France (VM), the Center for Clinical Studies, University Hospital, Jena, Germany (TL), the Department of Anesthesiology and Acute Postoperative & Transitional Pain Service, Cliniques Universitaires St Luc - University Catholic of Louvain, Brussels, Belgium (PL), Anaesthesia and Intensive Care Department, Ambroise Paré Hospital, APHP, Boulogne Billancourt, France; Université Paris-Saclay, UVSQ, Inserm, LPPD, Boulogne, France (HK, DF), the Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and SleepWell Research Programme, University of Helsinki (EK), the Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster UKM, Munster, Germany (EMPZ), the Department of Anaesthesiology and Intensive Care, Jena University Hospital Friedrich Schiller University, Jena, Germany (MK, WM, CW).

European Journal of Anaesthesiology
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PubMed
Summary

This study found chronic postsurgical pain (CPSP) affects 10.5% of patients, varying by surgery type. While no predictive score was identified, new data on CPSP incidence and characteristics were gathered.

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Area of Science:

  • Pain Medicine
  • Surgical Outcomes
  • Clinical Epidemiology

Background:

  • Chronic postsurgical pain (CPSP) is a significant clinical challenge.
  • Large-scale prospective studies are essential for understanding CPSP incidence, characteristics, and risk factors.
  • A multicentre European prospective observational trial (NCT03834922) was conducted.

Purpose of the Study:

  • To identify predictive factors for chronic postsurgical pain (CPSP).
  • To develop a scoring system for predicting CPSP at 6 months post-surgery.
  • To analyze the incidence, characteristics, and consequences of CPSP.

Main Methods:

  • A prospective observational study involving patients undergoing breast cancer surgery, sternotomy, endometriosis surgery, or total knee arthroplasty (TKA).
  • Standardized questionnaires were administered at multiple time points (1, 3, 7 days; 1, 3, 6 months) post-surgery.
  • Follow-up was conducted via email, telephone, or interviews.

Main Results:

  • A total of 3297 patients were enrolled, with 2494 followed for 6 months.
  • The overall incidence of CPSP at 6 months was 10.5%, with variations by surgical type (sternotomy 6.9%, breast 7.4%, TKA 12.9%, endometriosis 16.2%).
  • Neuropathic pain characteristics were common across all surgery types (33.3%–67.6%), and severe CPSP negatively impacted well-being and quality of life.

Conclusions:

  • The study did not yield a new predictive score for CPSP.
  • Reliable data on CPSP incidence, characteristics, and consequences were generated from a large European cohort.
  • Further research is needed to confirm new hypotheses regarding the time course of CPSP, its neuropathic component, and outcomes after endometriosis surgery.