Chronic postsurgical pain in Europe

Fletcher, Dominique; Stamer, Ulrike; Pogatzki-Zahn, Esther; Zaslansky, Ruth; Tanase, Narcis Valentin; Perruchoud, Christophe; Kranke, Peter; Komann, Marcus; Lehman, Thomas J. A.; Meißner, Winfried

doi:10.1097/eja.0000000000000319

Cited by 448 publications

(397 citation statements)

References 32 publications

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“…The length of pain exposure in the acute postoperative period is associated with the development of chronic postsurgical pain [40,41]. Optimal pain reduction in the acute postoperative period seems to be important, not only for fast recovery and rehabilitation in the short-term, but for the prevention of CPSP as well [42,43].…”

Section: Discussionmentioning

confidence: 99%

Peri-operative pain in patients experiencing bariatric surgery

Kumar¹,

Soekarman²,

Singh³

et al. 2017

Med Clin Arch

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A review of the literature was performed to identify follow-up studies on pain and bariatric surgery (gastric band, gastric sleeve or R-en-Y gastric bypass) as intervention. The main objective of this study was to find information on the prevalence of chronic pain in patients undergoing any of the mentioned surgical techniques and the incidence of chronic postsurgical pain after bariatric surgery.16 studies were included for further analysis with over 2000 subjects. 2/3 of the information was on bypass surgery. "Short term" studies with data on pain within 3 months after surgery were randomized controlled trials (RCTs) comparing surgical techniques or analgesia. Pre-operative pain status had not been documented. However, peri-operative pain management was reported in detail. In 8 observational studies, pain data were available exceeding 3 months after surgery ("long term" studies). While pre-operative pain data were reported in the latter studies, in over half the anatomic location of the pain had not been specified. An accurate estimation of the incidence of chronic postsurgical pain after bariatric surgery was not possible based on the available data. The number of comparable studies was low and the anatomic location of the pain had not been specified. Data on pain between 1 week and 6 months after surgery are lacking. This period is important, since it contains the time point after which the measured pain can be defined as chronic.

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Section: Discussionmentioning

confidence: 99%

Peri-operative pain in patients experiencing bariatric surgery

Kumar¹,

Soekarman²,

Singh³

et al. 2017

Med Clin Arch

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“…THA is in eleventh place of the top 40 surgical procedures 1. In other studies, risk factors for chronic postsurgical pain (CPSP) were chronic preoperative pain, orthopedic surgery, and percentage of time with severe pain on day 1 after surgery 2. The quality of acute postoperative pain management is far from satisfactory,3 despite the availability of a large number of studies on techniques and medication.…”

Section: Objectivementioning

confidence: 99%

Can consistent benchmarking within a standardized pain management concept decrease postoperative pain after total hip arthroplasty? A prospective cohort study including 367 patients

Benditz

Greimel

Auer

et al. 2016

JPR

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BackgroundThe number of total hip replacement surgeries has steadily increased over recent years. Reduction in postoperative pain increases patient satisfaction and enables better mobilization. Thus, pain management needs to be continuously improved. Problems are often caused not only by medical issues but also by organization and hospital structure. The present study shows how the quality of pain management can be increased by implementing a standardized pain concept and simple, consistent, benchmarking.MethodsAll patients included in the study had undergone total hip arthroplasty (THA). Outcome parameters were analyzed 24 hours after surgery by means of the questionnaires from the German-wide project “Quality Improvement in Postoperative Pain Management” (QUIPS). A pain nurse interviewed patients and continuously assessed outcome quality parameters. A multidisciplinary team of anesthetists, orthopedic surgeons, and nurses implemented a regular procedure of data analysis and internal benchmarking. The health care team was informed of any results, and suggested improvements. Every staff member involved in pain management participated in educational lessons, and a special pain nurse was trained in each ward.ResultsFrom 2014 to 2015, 367 patients were included. The mean maximal pain score 24 hours after surgery was 4.0 (±3.0) on an 11-point numeric rating scale, and patient satisfaction was 9.0 (±1.2). Over time, the maximum pain score decreased (mean 3.0, ±2.0), whereas patient satisfaction significantly increased (mean 9.8, ±0.4; p<0.05). Among 49 anonymized hospitals, our clinic stayed on first rank in terms of lowest maximum pain and patient satisfaction over the period.ConclusionResults were already acceptable at the beginning of benchmarking a standardized pain management concept. But regular benchmarking, implementation of feedback mechanisms, and staff education made the pain management concept even more successful. Multidisciplinary teamwork and flexibility in adapting processes seem to be highly important for successful pain management.

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“…At 12 months, the incidence of moderate pain was 11.8% and of severe pain 2.2%. NP affected 35.4% of patients with moderate pain and 57.1% of patients with severe pain 12 . An Italian study collecting data via e-mail or telephone using BPI and DN4 and including 235 patients, has shown that the incidence of chronic postsurgical pain at 6 month was 45.2% for mild pain, 15.9% for moderate pain and 2.7% for severe pain, while the incidence of chronic post-surgical pain at 12 months was 35.9%, 11.8% and 2.5%, respectively for mild, moderate and severe pain.…”

Section: Chronic Post-surgical Painmentioning

confidence: 99%

“…The association between acute post-surgical pain intensity and further development of chronic pain was observed after breast surgery, thoracotomy and groin hernia repair, however, whether this association is an indication of the extension of neuroplasticity changes induced by surgery, by lack of adequate analgesia or by preoperative predisposing factors is still not totally explained [30][31][32] . A European study has evidenced chronic pre-surgical pain, orthopedic surgery and percentage of time with severe pain in the first post-surgical day as risk factors for chronic post-surgical pain 12 . An Italian study has also evidenced that severe pain during the first 24 post-surgical hours seems to be predictor of chronic post-surgical pain 13 .…”

Section: Pathophysiology Of Neuropathic Pain After Peripheral Nerve Imentioning

confidence: 99%