Incidence and Risk Factors of Chronic Postoperative Pain in Same-day Surgery: A Prospective Cohort Study

Melodie Fanay Boko¹, Ashish K Khanna², Frederick D'Aragon³

¹Department of Medicine, University of Montreal, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre, Montreal, Quebec, Canada.

Anesthesiology

|April 26, 2024

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View abstract on PubMed

Summary

Chronic postsurgical pain after same-day surgery is common, affecting 12% of patients and often being moderate to severe. This persistent pain primarily impacts individuals without prior chronic pain conditions.

Area of Science:

Pain Medicine
Surgical Outcomes
Epidemiology

Background:

Same-day surgery rates have significantly increased globally.
Evidence regarding chronic postsurgical pain following ambulatory surgery is limited.
Understanding pain trajectories post-ambulatory surgery is crucial for patient care.

Purpose of the Study:

To assess the incidence and characteristics of chronic postsurgical pain (CPP) 90 days after ambulatory surgery.
To identify risk factors associated with developing CPP in this patient population.
To evaluate the severity of CPP in patients undergoing same-day procedures.

Main Methods:

An international, multicenter prospective cohort study was conducted.
Included patients aged 45+ with comorbidities or 65+.
Pain was assessed using the Brief Pain Inventory, defining CPP as a >1 point increase in site pain and moderate-to-severe CPP as a score >4 at 90 days.

Main Results:

12% of 2,054 participants developed CPP, with 93.1% experiencing new onset pain.
Moderate to severe CPP occurred in 9% of participants.
Risk factors included active smoking, orthopedic, plastic, breast, and vascular surgery, and Hispanic/Latino or First Nations/Native ethnicity.

Conclusions:

Persistent postsurgical pain is a common outcome after same-day ambulatory surgery.
The majority of CPP cases are new onset and moderate to severe.
Identifying specific surgical procedures and patient demographics can help predict CPP risk.

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