Risk stratification for the development of chronic postsurgical pain
The past 20 years have seen an increasing recognition of the burden of chronic pain after surgery and other trauma. There is now good evidence that chronic postsurgical pain (CPSP) is by far more common and more severe than previously thought with far-reaching consequences for quality of life and function of those affected. There are also significant implications and costs for health care systems and society as a whole.
Table 1 highlights this by showing the incidence of chronic pain after a number of surgical interventions, as well as the proportion of patients who experience severe pain and the contribution of neuropathic pain features to this presentation. The wide variability of these numbers is largely due to methodological differences, caused by the use of variable definitions for chronicity, in particular regarding the time frame applied for measurement (between 2 and 12 months). Other factors include differences in study design (eg, cross-sectional, prevalence surveys or prospective surgical cohort studies), as well as variable assessment of preoperative chronic pain and measurement of postoperative pain.