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Prevalence, characteristics and risk factors of chronic postsurgical pain after laparoscopic colorectal surgery

2015; Lippincott Williams & Wilkins; Volume: 32; Issue: 10 Linguagem: Inglês

10.1097/eja.0000000000000268

1365-2346

Jean Joris, Mathieu Georges, K Medjahed, Didier Ledoux, Gaëlle Damilot, C. Ramquet, Carla Coïmbra, Laurent Kohnen, Jean François Brichant,

Cardiac, Anesthesia and Surgical Outcomes

The prevalence of chronic postsurgical pain (CPSP) is a critical medical problem with economic implications. Its prevalence after gastrointestinal surgery is not well documented, particularly when a laparoscopic approach is used.The aim of the study was to determine the prevalence, the characteristics and the risk factors for CPSP after laparoscopic colorectal surgery.A retrospective analysis using a postal questionnaire.The study was conducted at a university teaching hospital.Patients who underwent laparoscopic colorectal surgery from April 2008 until December 2011 (n = 260). No epidural analgesia was used.Postoperative pain intensity, incidence and characteristics of CPSP, and impact on quality of life and sleep.Of 199 responses, 33 patients (17%) reported chronic pain at a median [interquartile range, IQR] of 38 [27 to 55] months after laparoscopic surgery with a median intensity of 4 [3 to 5]. CPSP had a negative impact on the quality of life in 84% of patients and on sleep in 43%. CPSP required regular analgesic(s) intake in 54% patients. Using a backward stepwise multivariate logistic regression model, the following variables were determined as independent risk factors for CPSP: redo surgery for anastomotic leakage (P = 0.01), inflammatory bowel disease (IBD) as the indication for surgery (P = 0.01) and preoperative pain (P = 0.05).The incidence of CPSP after laparoscopic colorectal surgery (17%) is similar to those reported in the literature after laparotomy. Risk factors are redo surgery for postoperative peritonitis, IBD and preoperative pain.EudraCT 2012-005712-25.