Valeria Martinez, Thomas Lehman, Patricia Lavand'homme, Hakim Harkouk, Eija Kalso, Esther M Pogatzki-Zahn, Marcus Komann, Winfried Meissner, Claudia Weinmann, Dominique Fletcher
{"title":"手术后慢性疼痛：欧洲调查。","authors":"Valeria Martinez, Thomas Lehman, Patricia Lavand'homme, Hakim Harkouk, Eija Kalso, Esther M Pogatzki-Zahn, Marcus Komann, Winfried Meissner, Claudia Weinmann, Dominique Fletcher","doi":"10.1097/EJA.0000000000001974","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Chronic postsurgical pain (CPSP) is a clinical problem, and large prospective studies are needed to determine its incidence, characteristics, and risk factors.</p><p><strong>Objective: </strong>To find predictive factors for CPSP in an international survey.</p><p><strong>Design: </strong>Observational study.</p><p><strong>Setting: </strong>Multicentre European prospective observational trial.</p><p><strong>Patients: </strong>Patients undergoing breast cancer surgery, sternotomy, endometriosis surgery, or total knee arthroplasty (TKA).</p><p><strong>Method: </strong>Standardised questionnaires were completed by the patients at 1, 3, and 7 days, and at 1, 3, and 6 months after surgery, with follow-up via E-mail, telephone, or interview.</p><p><strong>Main outcome measure: </strong>The primary goal of NIT-1 was to propose a scoring system to predict those patient likely to have CPSP at 6 months after surgery.</p><p><strong>Results: </strong>A total of 3297 patients were included from 18 hospitals across Europe and 2494 patients were followed-up for 6 months. The mean incidence of CPSP at 6 months was 10.5%, with variations depending on the type of surgery: sternotomy 6.9%, breast surgery 7.4%, TKA 12.9%, endometriosis 16.2%. At 6 months, neuropathic characteristics were frequent for all types of surgery: sternotomy 33.3%, breast surgery 67.6%, TKA 42.4%, endometriosis 41.4%. One-third of patients experienced CPSP at both 3 and 6 months. Pre-operative pain was frequent for TKA (leg pain) and endometriosis (abdomen) and its frequency and intensity were reduced after surgery. Severe CPSP and a neuropathic pain component decreased psychological and functional wellbeing as well as quality of life. No overarching CPSP risk factors were identified.</p><p><strong>Conclusion: </strong>Unfortunately, our findings do not offer a new CPSP predictive score. However, we present reliable new data on the incidence, characteristics, and consequences of CPSP from a large European survey. Interesting new data on the time course of CPSP, its neuropathic pain component, and CPSP after endometriosis surgery generate new hypotheses but need to be confirmed by further research.</p><p><strong>Trial registration: </strong>clinicaltrials.gov ID: NCT03834922.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":null,"pages":null},"PeriodicalIF":4.2000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990022/pdf/","citationCount":"0","resultStr":"{\"title\":\"Chronic postsurgical pain: A European survey.\",\"authors\":\"Valeria Martinez, Thomas Lehman, Patricia Lavand'homme, Hakim Harkouk, Eija Kalso, Esther M Pogatzki-Zahn, Marcus Komann, Winfried Meissner, Claudia Weinmann, Dominique Fletcher\",\"doi\":\"10.1097/EJA.0000000000001974\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Chronic postsurgical pain (CPSP) is a clinical problem, and large prospective studies are needed to determine its incidence, characteristics, and risk factors.</p><p><strong>Objective: </strong>To find predictive factors for CPSP in an international survey.</p><p><strong>Design: </strong>Observational study.</p><p><strong>Setting: </strong>Multicentre European prospective observational trial.</p><p><strong>Patients: </strong>Patients undergoing breast cancer surgery, sternotomy, endometriosis surgery, or total knee arthroplasty (TKA).</p><p><strong>Method: </strong>Standardised questionnaires were completed by the patients at 1, 3, and 7 days, and at 1, 3, and 6 months after surgery, with follow-up via E-mail, telephone, or interview.</p><p><strong>Main outcome measure: </strong>The primary goal of NIT-1 was to propose a scoring system to predict those patient likely to have CPSP at 6 months after surgery.</p><p><strong>Results: </strong>A total of 3297 patients were included from 18 hospitals across Europe and 2494 patients were followed-up for 6 months. The mean incidence of CPSP at 6 months was 10.5%, with variations depending on the type of surgery: sternotomy 6.9%, breast surgery 7.4%, TKA 12.9%, endometriosis 16.2%. At 6 months, neuropathic characteristics were frequent for all types of surgery: sternotomy 33.3%, breast surgery 67.6%, TKA 42.4%, endometriosis 41.4%. One-third of patients experienced CPSP at both 3 and 6 months. Pre-operative pain was frequent for TKA (leg pain) and endometriosis (abdomen) and its frequency and intensity were reduced after surgery. Severe CPSP and a neuropathic pain component decreased psychological and functional wellbeing as well as quality of life. No overarching CPSP risk factors were identified.</p><p><strong>Conclusion: </strong>Unfortunately, our findings do not offer a new CPSP predictive score. However, we present reliable new data on the incidence, characteristics, and consequences of CPSP from a large European survey. Interesting new data on the time course of CPSP, its neuropathic pain component, and CPSP after endometriosis surgery generate new hypotheses but need to be confirmed by further research.</p><p><strong>Trial registration: </strong>clinicaltrials.gov ID: NCT03834922.</p>\",\"PeriodicalId\":11920,\"journal\":{\"name\":\"European Journal of Anaesthesiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2024-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990022/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Anaesthesiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/EJA.0000000000001974\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/2/27 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Anaesthesiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/EJA.0000000000001974","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/27 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Background: Chronic postsurgical pain (CPSP) is a clinical problem, and large prospective studies are needed to determine its incidence, characteristics, and risk factors.
Objective: To find predictive factors for CPSP in an international survey.
Design: Observational study.
Setting: Multicentre European prospective observational trial.
Patients: Patients undergoing breast cancer surgery, sternotomy, endometriosis surgery, or total knee arthroplasty (TKA).
Method: Standardised questionnaires were completed by the patients at 1, 3, and 7 days, and at 1, 3, and 6 months after surgery, with follow-up via E-mail, telephone, or interview.
Main outcome measure: The primary goal of NIT-1 was to propose a scoring system to predict those patient likely to have CPSP at 6 months after surgery.
Results: A total of 3297 patients were included from 18 hospitals across Europe and 2494 patients were followed-up for 6 months. The mean incidence of CPSP at 6 months was 10.5%, with variations depending on the type of surgery: sternotomy 6.9%, breast surgery 7.4%, TKA 12.9%, endometriosis 16.2%. At 6 months, neuropathic characteristics were frequent for all types of surgery: sternotomy 33.3%, breast surgery 67.6%, TKA 42.4%, endometriosis 41.4%. One-third of patients experienced CPSP at both 3 and 6 months. Pre-operative pain was frequent for TKA (leg pain) and endometriosis (abdomen) and its frequency and intensity were reduced after surgery. Severe CPSP and a neuropathic pain component decreased psychological and functional wellbeing as well as quality of life. No overarching CPSP risk factors were identified.
Conclusion: Unfortunately, our findings do not offer a new CPSP predictive score. However, we present reliable new data on the incidence, characteristics, and consequences of CPSP from a large European survey. Interesting new data on the time course of CPSP, its neuropathic pain component, and CPSP after endometriosis surgery generate new hypotheses but need to be confirmed by further research.
期刊介绍：
The European Journal of Anaesthesiology (EJA) publishes original work of high scientific quality in the field of anaesthesiology, pain, emergency medicine and intensive care. Preference is given to experimental work or clinical observation in man, and to laboratory work of clinical relevance. The journal also publishes commissioned reviews by an authority, editorials, invited commentaries, special articles, pro and con debates, and short reports (correspondences, case reports, short reports of clinical studies).
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