Persistent Postoperative Pain after Cardiac Surgery: Incidence, Characterization, Associated Factors and its impact in Quality of Life

Abstract

This is the first study comprehensively describing PPP after CS and identifying NP in half of them. Our results support the important role that PPP plays after CS in considering its interference in patients' daily life and their lower QoL, which deserves the attention of health care professionals in order to improve prevention, assessment and treatment of these patients. WHAT DOES THIS STUDY ADD?: This study comprehensively describes persistent postoperative pain (PPP) after cardiac surgery (CS) and identifies neuropathic pain (NP) in half of them. Our results support the important role that PPP plays after CS in considering its interference in patients' daily life and their lower quality of life.

Do depression and anxiety profiles over time predict persistent post‐surgical pain? A study in cardiac surgery patients

“…The development of persistent post-surgical pain (PPSP) is a significant problem (Katz and Seltzer, 2009) associated with decreased quality of life (QoL) and increased suffering (Joshi and Ogunnaike, 2005;Peters et al, 2010;Guimaraes-Pereira et al, 2016). PPSP refers to the presence of pain post-surgically that (1) was not present pre-surgically or increased in intensity post-surgically; (2) lasts at least 3-6 months after surgery and impacts on one's life; (3) could have a delayed onset following surgery; (4) is located at the surgical site and (5) is not due to other causes than surgery (Werner and Kongsgaard, 2014).…”

Chronic postoperative pain: recent findings in understanding and management

“…Several of the most common previously described risk factors for CPOP are confirmed: female gender (in abdominal 9 and cardiac surgery 21 ), younger age (in abdominal 9 , breast 17, 20 , cardiac 21 , and inguinal hernia surgery 26 ), preoperative pain (in abdominal 10 , breast 17, 20 , and outpatient surgery 7 , hysterectomy 25 , TKA 34 , and thoracotomy 40, 42 ), psychological states (anxiety in abdominal surgery 9 and thyroidectomy 45 , distress 18 and PTSD 15 in breast surgery, catastrophizing in cardiac surgery 21 and lumbar laminectomy 37 , and fear and lack of optimism in outpatient surgery 7 ), and postoperative pain (in breast 17, 20 , cardiac 21 , shoulder replacement 36 , and outpatient surgery 7 , hysterectomy 24, 25 , and thoracotomy 41 ). The duration of severe pain in the initial 24 hours postoperatively, as opposed to the pain intensity, predicts the chance of CPOP 2 .…”

“…Recent studies in patients following sternotomy found the incidence of CPOP at 3 months to be 43% 21 but only 11% at 12 months and 3.8% at 5 years 22 . In 2016, Setälä et al .…”

“…demonstrated that the area of hyperalgesia around the sternotomy wound, on postoperative day 4, was not associated with CPOP at 4–6 months 23 , and Guimarães-Pereira et al . found the risk factors to be younger age, female gender, higher body mass index, catastrophizing, coronary artery bypass graft, osteoarthritis, history of previous surgery, and moderate-to-severe acute postoperative pain 21 .…”

Primary care management of chest pain after coronary artery bypass surgery

“…Over 16 000 operations were performed in the UK in 2015 2. Recurrent or chronic chest pain after CABG can be extremely worrying for the patient and affect their quality of life 3. In a prospective cohort study (183 patients), a third of patients reported chronic chest pain on movement and 17% reported chest pain at rest at one year after CABG 4.…”