The neuropathic component in persistent postsurgical pain: A systematic literature review

Simon Haroutiunian, Lone Nikolajsen, Nanna Brix Finnerup, Troels Staehelin Jensen

Research output: Contribution to journalArticlepeer-review

325 Scopus citations


Persistent postsurgical pain (PPSP) is a frequent and often disabling complication of many surgical procedures. Nerve injury-induced neuropathic pain (NeuP) has repeatedly been proposed as a major cause of PPSP. However, there is a lack of uniformity in NeuP assessment across studies, and the prevalence of NeuP may differ after various surgeries. We performed a systematic search of the PubMed, CENTRAL, and Embase databases and assessed 281 studies that investigated PPSP after 11 types of surgery. The prevalence of PPSP in each surgical group was examined. The prevalence of NeuP was determined by applying the recently published NeuP probability grading system. The prevalence of probable or definite NeuP was high in patients with persistent pain after thoracic and breast surgeries - 66% and 68%, respectively. In patients with PPSP after groin hernia repair, the prevalence of NeuP was 31%, and after total hip or knee arthroplasty it was 6%. The results suggest that the prevalence of NeuP among PPSP cases differs in various types of surgery, probably depending on the likelihood of surgical iatrogenic nerve injury. Because of large methodological variability across studies, a more uniform approach is desirable in future studies for evaluating persistent postsurgical NeuP.

Original languageEnglish
Pages (from-to)95-102
Number of pages8
Issue number1
StatePublished - Jan 2013


  • Chronic postoperative pain
  • Neuropathic pain
  • Persistent postsurgical pain
  • Systematic review


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