Chronic postsurgical pain: A European survey

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.