Chronic post-surgical pain after colon surgery in patients included in an enhanced recovery program.
Aged
Analgesics, Opioid
/ therapeutic use
Anesthetics, Local
/ therapeutic use
Cohort Studies
Colon
/ surgery
Databases, Factual
Digestive System Surgical Procedures
/ adverse effects
Enhanced Recovery After Surgery
Female
Humans
Length of Stay
Levobupivacaine
/ therapeutic use
Male
Middle Aged
Pain Management
Pain, Postoperative
/ drug therapy
Retrospective Studies
Sufentanil
/ therapeutic use
Journal
Acta anaesthesiologica Scandinavica
ISSN: 1399-6576
Titre abrégé: Acta Anaesthesiol Scand
Pays: England
ID NLM: 0370270
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
09
01
2018
revised:
01
02
2019
accepted:
19
03
2019
pubmed:
11
4
2019
medline:
1
8
2020
entrez:
11
4
2019
Statut:
ppublish
Résumé
Enhanced recovery after surgery (ERAS) program improves immediate recovery. Beyond immediate benefits, long-term impact of ERAS implementation is not yet evident. This retrospective single-center cohort study investigates prevalence and characteristics of chronic post-surgical pain (CPSP) in patients who underwent colon surgery. Two hundred and ninety-seven patients enrolled prospectively in our ERAS database were contacted by mail to question the presence of CPSP. In case of CPSP, intensity, location, and type of pain, impact of pain on quality of life and treatment taken were assessed. Post-operative pain experience during hospital stay, recall of pain, and discomfort duration when back home were assessed in all patients. Comparison between patients with and without CPSP was made to approach the risk factors of CPSP in this population. At 27 months after colon surgery, 25/198 patients reported CPSP (12.6%) and pain was severe in 5 patients (2.5%). CPSP had a deep abdominal component in 56% of patients and a parietal component in 20% of patients. Patients with CPSP+ differed from patients CPSP- for pre-operative pain presence (56% vs 24.8%, P = 0.004), recalled post-operative pain intensity (4 vs 3, P = 0.045), duration of discomfort after discharge (2 vs 1 weeks, P = 0.035). Pre-operative pain was found as a significant CPSP risk factor (odds ratio 1.34; 95% CI: 1.05-1.70). CPSP prevalence after laparoscopic colon surgery seems not much affected by ERAS context. Pre-operative presence of pain emerged as an important risk factor. These findings should be confirmed in a prospective multicenter study.
Sections du résumé
BACKGROUND
Enhanced recovery after surgery (ERAS) program improves immediate recovery. Beyond immediate benefits, long-term impact of ERAS implementation is not yet evident. This retrospective single-center cohort study investigates prevalence and characteristics of chronic post-surgical pain (CPSP) in patients who underwent colon surgery.
METHODS
Two hundred and ninety-seven patients enrolled prospectively in our ERAS database were contacted by mail to question the presence of CPSP. In case of CPSP, intensity, location, and type of pain, impact of pain on quality of life and treatment taken were assessed. Post-operative pain experience during hospital stay, recall of pain, and discomfort duration when back home were assessed in all patients. Comparison between patients with and without CPSP was made to approach the risk factors of CPSP in this population.
RESULTS
At 27 months after colon surgery, 25/198 patients reported CPSP (12.6%) and pain was severe in 5 patients (2.5%). CPSP had a deep abdominal component in 56% of patients and a parietal component in 20% of patients. Patients with CPSP+ differed from patients CPSP- for pre-operative pain presence (56% vs 24.8%, P = 0.004), recalled post-operative pain intensity (4 vs 3, P = 0.045), duration of discomfort after discharge (2 vs 1 weeks, P = 0.035). Pre-operative pain was found as a significant CPSP risk factor (odds ratio 1.34; 95% CI: 1.05-1.70).
CONCLUSION
CPSP prevalence after laparoscopic colon surgery seems not much affected by ERAS context. Pre-operative presence of pain emerged as an important risk factor. These findings should be confirmed in a prospective multicenter study.
Substances chimiques
Analgesics, Opioid
0
Anesthetics, Local
0
Levobupivacaine
A5H73K9U3W
Sufentanil
AFE2YW0IIZ
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
931-938Informations de copyright
© 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.