The prevalence of chronic chest and leg pain following cardiac surgery: a historical cohort study

Abstract

Chronic pain after surgery is recognised as an important post-operative complication; recent studies have shown up to 30% of patients reporting persistent pain following mastectomy and inguinal hernia repair. No large-scale studies have investigated the epidemiology of chronic pain at two operative sites following coronary artery bypass grafting (CABG). This paper reports the follow-up of a cohort of 1348 patients who underwent cardiac surgery between 1996 and 2000 at one cardiothoracic unit in northeast Scotland. Chronic pain was defined as pain in the location of surgery, different from that suffered pre-operatively, arising post-operatively and persisting beyond 3 months. The survey questionnaire consisted of the short-form-36 (SF-36), Rose angina questionnaire, McGill pain questionnaire and the University of California and San Francisco (UCSF) pain service questionnaire. Of the 1080 responders, 130 reported chronic chest pain, 100 chronic post-saphenectomy pain and 194 reported pain at both surgical sites. The cumulative prevalence of post-cardiac surgery pain was 39.3% (CI(95) 36.4-42.2%) and mean time of 28 months since surgery (SD 15.3 months). Patients who reported pain at both sites had lower quality of life scores across all eight health domains compared to patients with pain at one site only and those who were pain-free. Prevalence of chronic pain decreased with age, from 55% in those aged under 60 years to 34% in patients over 70 years. Patients with pre-operative angina and those who were overweight or obese (BMI>/=25) at the time of surgery were more likely to report chronic pain. Chronic pain following median sternotomy and saphenous vein harvesting is more common than hitherto reported and that patients undergoing CABG should be warned of this possibility.

A clinical study of the incidence and disability caused by mesh neuralgia after inguinal mesh hernioplasty and the effects of prophylactic ilioinguinal neurectomy and its role in preventing chronic groin pain after inguinal hernioplasty

“…[4][5][6][7][8][9][10][11][12][13] From these reviews and studies using a systematic collection of data, the estimated incidences of chronic pain after various procedures are as under:…”

Risk Factors for Persistent Postsurgical Pain in Women Undergoing Hysterectomy Due to Benign Causes: A Prospective Predictive Study

“…4,11,13,21,31,36,40,71 The protective effect of increased age has been related to a reduction in peripheral nociceptive function. 64,84 The Role of Psychological Predictors…”

“…DN-4 5,6 : previous research described PPSP as a potential neuropathic pain. 11,34,71 This instrument evaluates pain characteristics/quality through 10 items. Seven of them refer to specific pain sensory descriptors, such as burning, pinpricking, or numbness, and patients answered if their pain had those characteristics through a dichotomous format (yes or no).…”

The prevalence of postoperative pain in the first 48 hours following day surgery at a tertiary hospital in Nairobi

“…Persistent postoperative pain is an unpleasant sensory and emotional experience following surgery. It is thought to be caused by nerve injury 10,11 , and neuroplastic change in the central nervous system induced by high-intensity pain in the first days following surgery 12 . Currently pain literature supports the concept that even a brief experience of moderate to severe acute pain can lead to reorganization of neurons in the higher centre 13,14,15 .…”