TY - JOUR
T1 - The neuropathic component in persistent postsurgical pain
T2 - A systematic literature review
AU - Haroutiunian, Simon
AU - Nikolajsen, Lone
AU - Finnerup, Nanna Brix
AU - Jensen, Troels Staehelin
N1 - Funding Information:
The authors would like to thank Edith Clausen, Cand.Scient.Bibl. (Aarhus University Hospital, Aarhus, Denmark), for assistance with performing the systematic literature search, and Helle O. Andersen (Danish Pain Research Center, Aarhus, Denmark) for English-language revision. The study was supported by a grant from the Lundbeck Foundation , Vestagervej 17, 2900 Hellerup, Denmark ( R17-A1679 ). The research leading to these results is part of the Europain Collaboration, which has received support from the Innovative Medicines Initiative Joint Undertaking, under grant agreement no 115007, resources of which are composed of financial contribution from the European Union’s Seventh Framework Programme (FP7/2007–2013) and EFPIA companies in kind contribution; www.imi.europa.eu.
PY - 2013/1
Y1 - 2013/1
N2 - 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.
AB - 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.
KW - Chronic postoperative pain
KW - Neuropathic pain
KW - Persistent postsurgical pain
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=84871636255&partnerID=8YFLogxK
U2 - 10.1016/j.pain.2012.09.010
DO - 10.1016/j.pain.2012.09.010
M3 - Article
C2 - 23273105
AN - SCOPUS:84871636255
SN - 0304-3959
VL - 154
SP - 95
EP - 102
JO - Pain
JF - Pain
IS - 1
ER -