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Epidemiology of persistent postoperative pain: Association of persistent pain and sensory abnormalities.
Scandinavian Journal of Pain 2017 December 30
Background The prevalence of persistent postoperative pain in the general population is poorly documented, but clinical studies indicate that the problem is common. Aim The aim of this study was (1) to assess the prevalence of persistent postoperative pain among individuals operated during the last 3 years in a general population and (2) to describe factors associated with chronic postoperative pain. Materials and methods As part of a cross-sectional health survey in the municipality of Tromsø, North Norway, all participants answered questions on surgery, persisting pain and sensory abnormalities in the area of surgery. N = 12,984. Age 30-87 years, median 59. 53.4% women. Pain intensity was reported using a 0-10 Numeric Rating Scale (0-10 NRS). Logistic regression was used to reveal any associations between pain and self-reported hyposensitivity, hypersensitivity and allodynia. Results 2316 individuals (17.8%) had surgery between 3 months and 3 years prior to the survey. 826 (40.4%)of the 2044 who answered a questionnaire on postsurgical pain, reported having some degree of pain in the area of surgery. Of these 826 individuals, 45.2% had pain, when at worst, of moderate or severe intensity, i.e. 0-10 NRS of 4 or higher. The areas of surgery carrying the strongest association with persistent pain were (in descending order of frequency): (1) Shoulder/ upper arm [74.5% (108/145)], (2) back [73.9% (65/88)], (3) lungs [66.7% (8/12)], (4) knee/lower leg [63.7% (179/281)], (5) hand [58.8% (90/153)]. (6) hip/thigh [58.3% (74/127)] and (7) ankle/foot [58.7% (84/143)]. 18.3% (413) had reduced sensitivity in the area near the surgical scar, while 10.6% (240) reported hypersensitivity and 5.6% (127) allodynia. For those reporting hypoesthesia, the odds ratio (OR) for having pain was 2.71 (95% confidence interval 2.08-3.53), for those reporting hyperesthesia, OR was 4.82 (3.24-7.18) and for those with allodynia 5.83 (3.12-10.90). Conclusions 3 months or more after surgery, nearly half of the respondents report having pain in the area of surgery. In this survey, there is a strong association between persistent pain and the presence of both hyposensitivity, hypersensitivity and allodynia.
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