Chronic post-surgical pain and its impact on quality of life and recovery after surgery

Sousa, Gabriela; Mendonça, J.; Santos, Alice; Veiga, D.; Abelha, Fernando

doi:10.1097/00003643-201406001-00693

Cited by 3 publications

(3 citation statements)

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“…It is important to note that many studies in the initial stages of screening, and indeed in the literature, used validated multidimensional quality of recovery tools, 18 such as the PostopQRS, [46][47][48][49] QoR-15/QoR-40, 9,[50][51][52] Postoperative Recovery Profile, 53,54 PROMIS, 10 and others to determine a clinical effect. Yet, few studies examined risk factors for recovery and were excluded.…”

Section: Risk Of Bias and Certainty Assessmentsmentioning

confidence: 99%

Identifying risk factors for poor multidimensional recovery after major surgery: A systematic review

Ou-Young

Boggett

El-Ansary

et al. 2023

Acta Anaesthesiol Scand

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Traditional risk factors used for predicting poor postoperative recovery have focused on postoperative complications, adverse symptoms (nausea, pain), length of hospital stay, and patient quality of life. Despite these being traditional performance indicators of patient postoperative “status,” they may not fully define the multidimensional nature of patient recovery. The definition of postoperative recovery is thus evolving to include patient‐reported outcomes that are important to the patient. Previous reviews have focused on risk factors for the above traditional outcomes after major surgery. Yet, there remains a need for further study of risk factors predicting multidimensional patient‐focused recovery, and investigation beyond the immediate postoperative period after patients are discharged from the hospital. This review aimed to appraise the current literature identifying risk factors for multidimensional patient recovery.MethodsA systematic review without meta‐analysis was performed to qualitatively summarize preoperative risk factors for multidimensional recovery 4–6 weeks after major surgery (PROSPERO, CRD42022321626). We reviewed three electronic databases between January 2012 and April 2022. The primary outcome was risk factors for multidimensional recovery at 4–6 weeks. A GRADE quality appraisal and a risk of bias assessment were completed.ResultsIn total, 5150 studies were identified, after which 1506 duplicates were removed. After the primary and secondary screening, nine articles were included in the final review. Interrater agreements between the two assessors for the primary and secondary screening process were 86% (k = 0.47) and 94% (k = 0.70), respectively. Factors associated with poor recovery were found to include ASA grade, recovery tool baseline score, physical function, number of co‐morbidities, previous surgery, and psychological well‐being. Mixed results were reported for age, BMI, and preoperative pain. Due to the observational nature, heterogeneity, multiple definitions of recovery, and moderate risk of bias of the primary studies, the quality of evidence was rated from very low to low.ConclusionOur review found that there were few studies assessing preoperative risk factors as predictors for poor postoperative multidimensional recovery. This confirms the need for higher quality studies assessing risk for poor recovery, ideally with a consistent and multi‐dimensional definition of recovery.

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Section: Risk Of Bias and Certainty Assessmentsmentioning

confidence: 99%

Identifying risk factors for poor multidimensional recovery after major surgery: A systematic review

Ou-Young

Boggett

El-Ansary

et al. 2023

Acta Anaesthesiol Scand

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“…11 Another study reported that 23-60% of patients experienced residual pain after total ankle arthroplasty 12 ; nevertheless, a definition of residual pain was not described and follow-up ranged from two to more than seven years postoperatively. 12 Given that CPSP affects patients' quality of life by limiting their physical function and negatively impacting their psychologic state, 13 standardizing and disseminating the definition of CPSP in the context of elective mid/hindfoot and ankle surgery is fundamental for the assessment of effective management strategies.…”

Section: Résumémentioning

confidence: 99%

“…28 Similarly, Elliot et al reported significantly lower pain scores in participants who received a continuous infusion of 0.25% bupivacaine via a popliteal catheter after a single bolus popliteal block at 24 hr (VAS, 1.7 vs 3.7; P\0.01) and 48 hr (VAS, 1.3 vs 2.8; P\0.001) compared with participants receiving saline. 29 Additionally, Rahangdale et al found that pain was significantly reduced both with activity (P \ 0.05) and at rest (P \ 0.01) at 24 hr postoperatively and that analgesia duration was prolonged (median difference [range] 13 [7][8][9][10][11][12][13][14][15][16][17][18][19] hr) with adjunct perineural dexamethasone compared with normal saline. 31 Importantly, only two studies examined the impact of early pain management beyond 48 hr rafter surgery; one study evaluated pain at two weeks postoperatively, 31 and another at six months postoperatively.…”

Section: Include Include Includementioning

confidence: 99%

Perioperative pain management and chronic postsurgical pain after elective foot and ankle surgery: a scoping review

Stiegelmar

Beaupré

et al. 2019

Can J Anesth/J Can Anesth

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Purpose Chronic postsurgical pain (CPSP) can occur after elective mid/hindfoot and ankle surgery. Effective treatment approaches to prevent the development of CPSP in this population have not been extensively investigated. The impact of multimodal strategies to prevent CPSP following elective mid/hindfoot surgery is unknown because of both the heterogeneity of acute pain management and the lack of a recognized definition particular to this surgery. This review aimed to identify

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Smaller Inguinal Hernias are Independent Risk Factors for Developing Chronic Postoperative Inguinal Pain (CPIP)

et al. 2020

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Objective: Impact of inguinal hernia defect size as stratified by the European Hernia Society (EHS) classification I to III on the rate of chronic postoperative inguinal pain (CPIP). Background: CPIP is the most important complication after inguinal hernia repair. The impact of hernia defect size according to the EHS classification on CPIP is unknown. Methods: In total, 57,999 male patients from the Herniamed registry undergoing primary unilateral inguinal hernia repair including a 1-year follow-up were selected between September 1, 2009 and November 30, 2016. Using multivariable analysis, the impact of EHS inguinal hernia classification (EHS I vs EHS II vs EHS III and/or scrotal) on developing CPIP was investigated. Results: Multivariable analysis revealed for smaller inguinal hernias a significant higher rate of pain at rest [EHS I vs EHS II: odds ratio, OR = 1.350 (1.180–1.543), P < 0.001; EHS I vs EHS III and/or scrotal: OR = 1.839 (1.504–2.249), P < 0.001; EHS II vs EHS III and/or scrotal: OR = 1.363 (1.125–1.650), P = 0.002], pain on exertion [EHS I vs EHS II: OR = 1.342 (1.223–1.473), P < 0.001; EHS I vs EHS III and/or scrotal: OR = 2.002 (1.727–2.321), P < 0.001; EHS II vs EHS III and/or scrotal: OR = 1.492 (1.296; 1.717), P < 0.001], and pain requiring treatment [EHS I vs EHS II: OR = 1.594 (1.357–1.874), P < 0.001; EHS I vs EHS III and/or scrotal: OR = 2.254 (1.774–2.865), P < 0.001; EHS II vs EHS III and/or scrotal: OR = 1.414 (1.121–1.783), P = 0.003] at 1-year follow-up. Younger patients (<55 y) revealed higher rates of pain at rest, pain on exertion, and pain requiring treatment (each P < 0.001) with a significantly trend toward higher rates of pain in smaller hernias. Conclusions: Smaller inguinal hernias have been identified as an independent patient-related risk factor for developing CPIP.

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Chronic post-surgical pain and its impact on quality of life and recovery after surgery

Cited by 3 publications

References 0 publications

Identifying risk factors for poor multidimensional recovery after major surgery: A systematic review

Identifying risk factors for poor multidimensional recovery after major surgery: A systematic review

Perioperative pain management and chronic postsurgical pain after elective foot and ankle surgery: a scoping review

Smaller Inguinal Hernias are Independent Risk Factors for Developing Chronic Postoperative Inguinal Pain (CPIP)

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