Quintero O, Moyano J, Romero D. Postsurgical Chronic Pain: Incidence and Associated Factors in a Latin American Population. Int J Anesth Res. 2017;5(8):479-484.
479
OPEN ACCESS http://scidoc.org/IJAR.php
International Journal of Anesthesiology & Research (IJAR)
ISSN 2332-2780
*Corresponding Author:
Jairo Moyano, MD, PhD,
Deparmento de Anestesia, Servicio Clinica de Dolory Cuidado Paliativo, Hospital Universitario Fundación Santafe de Bogotá, Carrera 7 No. 117-15, Bogotá, Colombia.
Tel: 57 1 6199375/57-3123507164
Fax: 57 1 6122362
E-mail: jmoyano@unbosque.edu.co
Received: August 01, 2017
Accepted: September 23, 2017
Published: September 26, 2017
Citation: Quintero O, Moyano J, Romero D. Postsurgical Chronic Pain: Incidence and Associated Factors in a Latin American Population. Int J Anesth Res. 2017;5(8):479-484.
doi: http://dx.doi.org/10.19070/2332-2780-1700097
Copyright: Moyano J
©
2017. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution
and reproduction in any medium, provided the original author and source are credited.
Introduction
Chronic post-surgical pain (CPSP) is an adverse outcome in a
concerning number of surgical patients [1-5]. Considering that
the quantity of surgeries increases steadily, it is expected that
the number of people suffering from this type of chronic pain
(CP) will increase signiicantly. CPSP has been deined in differ-
ent ways but the key elements included in most deinitions are
persistent pain (continuous or intermittent) for more than 2 or 3
months after surgery when all other causes have been excluded.
CPSP predictive or risk factors may be associated with patient
characteristics (age, gender, depression, anxiety, lifestyle), speciic
conditions during the surgical procedure (nerve damage, surgi-
cal technique), as well as with treatmensts for comorbid condi-
tions such as radiotherapy and chemotherapy [6, 7]. Several stud-
ies have been conducted to estimate the incidence of CPSP in
different population groups and different types of surgeries [8,
9] on average 2-10% of patients undergoing surgical procedures
report persistent pain 1 year after surgery [10]. Due to a greater
acquaintance of its existence, and the need to control the negative
impact on the well-being of the patient, a growing request for
health services is expected to treat this modality of CP; however,
because of its partially unknown nature, it is possible that the
result of the treatments will not always be satisfactory. It is now
documented that there is wide variation in the presentation of this
type of pain, i.e. only some patients will develop it, while others
with similar characteristics will not; therefore, a multifactorial eti-
ology has been postulated. Nerve dysfunction has been reported
to be involved in the genesis of chronic post-surgical pain. Some
neuropathic features maybe be seen after surgical procedures (i.e.
thoracotomy) and maybe related to nerve damage, paroxysmal or
spontaneous pain, or autonomic signs, without evidence of on-
going tissue damage [11]. It is estimated that 1-3% of patients
undergoing surgical procedures develop acute neuropathic pain
and up to 56% of this group show progression from acute to CP
at the 1-year follow-up [7, 12, 13].
Among the psychological aspects, the acceptance of pain has
Postsurgical Chronic Pain: Incidence and Associated Factors in a Latin American Population
Research Article
Quintero O
1
, Moyano J
2*
, Romero D
1
1
Departamento de Anestesia, Fundacion Santafe de Bogota, Colombia.
2
Jefe Servicio Clinica de Dolor y Cuidado Paliativo, Deparmento de Anestesia, Hospital Universitario Fundación Santafe de Bogotá, Bogotá, Colombia.
Abstract
Introduction: It is important to know the incidence of Chronic Post-Surgical Pain (CPSP), to describe the distribution of risk
and protective factors associated with its presentation and to measure its impact on the quality of life. Due to the diversity of
factors that have been implicated as potentially associated with chronic post-surgical pain, it is important to look for differential
characteristics including emotional features to establish whether there are differences in the incidence of this type of pain.
Methods: A prospective analytical observational study was conducted in surgical patients at a University hospital from January 1
2014. Patients were asked to score their pain in the preoperative and immediate postoperative setting, and 3 months after surgery;
preoperative, intraoperative, and postoperative risk factors were assessed, and quality of life was assessed in the preoperative set-
ting and 3 months after surgery.
Results: We included 108 patients for a preliminary analysis, the study continued until the target sample size had been reached.
The global incidence of CPSP was 16.67% (95%CI 9.63-23.69). Risk factors were the presence of pain prior to surgery and the
duration of the surgical procedure. The presence of pain prior to surgery is a risk factor for the transition to CPSP.
Keywords: Chronic Pain; Quality of Life; Pain; Postoperative; Risk Factor.