Many variables contribute to a patient’s risk of chronic pain after surgery, and a new planning tool can help identify those variables before the procedure, according to new research. The study was published Feb. 19 on the website of Anesthesiology, the official medical journal of the American Society of Anesthesiologists.
“Our study rigorously examined patients’ risks of chronic postsurgical pain,” lead study author Antonio Montes Perez, MD, PhD, department of anesthesiology, Hospital del Mar in Barcelona, Spain, said in a news release. “We sought a tool that would reliably predict a patient’s risk preoperatively, at the time surgery is being planned. We developed a risk scoring system that can be used before surgery, when care planning and preventive measures are critically important.”
The researchers followed 2,929 patients undergoing three common types of surgery — hernia repair, hysterectomy and thoracotomy — for two years, assessing their pain at four, 12 and 24 months after surgery.
The study, referred to as GENDOLCAT, demonstrated there is substantial risk of chronic pain after surgery, with 18% of the patients developing chronic pain after four months, and 5.2% still experiencing chronic pain after 24 months.
The scoring system was developed based on six predictors among the patients in the study: type of surgery, age, physical health status, mental health status, preoperative pain in the surgical area and preoperative pain in another area.
According to Montes, risk scoring facilitates informed patient-physician discussion of strategies so together they can:
• Carefully consider the surgery.
• Plan to use the most appropriate pain relief techniques during recovery.
• Implement preventive measures before and during surgery.
• Set a pain monitoring schedule and follow-ups.
The researchers also tested for 90 genetic predictors, but this study found they did not play a role in the development of chronic pain after surgery.
“This scoring system improves the way we examine patients prior to surgery, which is based on an extensive physical examination rather than just clinical factors,” Montes said in the release. “As far as genetic influence, additional research should be conducted to determine whether or not other genetic factors not considered in this study contribute to chronic pain after surgery.”