Persistent postsurgical pain in a general population: Prevalence and predictors in the Tromsø study

Abstract

Population-based data on the prevalence of persistent postsurgical pain are scarce. This study aimed to assess the prevalence of persistent postsurgical pain in a general population and to describe associated physical, social, and psychological factors, including symptoms of nerve injury and sensitization. A cross-sectional survey was performed in northern Norway with questionnaire items covering surgery, pain, and sensory abnormalities in the area of surgery. Of the 12,982 participants, 24.0% (3111) had undergone one or more surgical procedures during the 3 years preceding the survey. Of these, 2043 had the surgery performed more than 3 months before the investigation. Persistent pain in the area of surgery was reported by 40.4% of the patients (826 of 2043), moderate or severe pain by 18.3% (373 of 2043). Hypoesthesia, hyperesthesia, or both was reported by 24.5% (501 of 2043). There were strong associations between sensory abnormalities and persistent pain, increasingly with higher pain intensities; odds ratios were 2.68 for hypoesthesia and 6.27 for hyperesthesia. Of the 826 individuals reporting persistent pain in the anatomical area of surgery, 51.0% reported chronic pain when questioned without specific reference to the surgery. The present study supports evidence from clinical studies of persistent postsurgical pain, indicating a high prevalence, but reveals large discrepancies in report of pain, depending on the questions asked and the context in which the questions are presented. Strong associations between sensory abnormalities and pain indicate neuropathic mechanisms in a major proportion of cases.

Potential strategies for preventing chronic postoperative pain: a practical approach: Continuing Professional Development

“…16,21 Also, long-term dysesthesia (hypo-or hyperesthesia) has been reported more frequently in patients with PPSP. 6 …”

“…2,3 D'autres revues plus récentes rapportent une incidence similaire. [4][5][6][7] Néanmoins, la définition elle-même de DCPC joue un rôle majeur dans l'incidence rapportée par les auteurs. Schug et coll.…”

“…[16][17][18][19][20][21] Aussi, des dysesthésies à long terme (hypo-ou hyperesthésies) sont plus fréquemment rapportées chez les patients qui présentent des DCPC. 6 …”

“…[4][5][6][7] Nevertheless, the definition used by the various authors to characterize PPSP plays a major role in the reported incidence. In 2012, Schug et al reported that the prevalence was reduced from 40% to 18% when considering only moderate to severe pain (pain [ 3 out of a score of 10) in the area of the surgery.…”

Neuropathic pain after bilateral sagittal split osteotomy: management and prevention

“…[13] The pain may be severe in 2-10% of these patients and is usually considered to be neuropathic. [14,15] Information about neuropathic pain following orthognathic surgery is sparse. [16,17] Borstlap et al [18] prospectively followed 222 patients after BSSO surgery and reported no incidence of neuropathic pain.…”