The incidence of chronic postoperative pain after major abdominal surgery

Abstract

Background: Chronic postoperative pain, pain that cannot be explained by other causes and that persist more than 2 months after surgery, occurs in 10-50% of patients after major abdominal surgery. Its subgroup, chronic neuropathic pain is very resistant to treatment. Intraoperative application of epidural analgesia and infusion of dexmedetomidine may infl-luence the incidence of chronic postoperative pain. Method: Adult surgical patients from the Clinical Department of Abdominal Surgery, UMC Ljubljana, who were planned to undergo one of the following procedures: stomach surgery, pancreas surgery or large intestinal resections, were included in this prospective study. All patients had epidural analgesia and intraoperative dexmedetomidine infusion. Three months after the procedure, structured questionnaire was sent to the patients. The intensity and quality of pain were assessed. DN4 (Douleur Neuropathique 4) and painDetect questionnaires were used. Results: We have received 42 (50%) properly filled DN4 questionnaires and 45 (53%) pain detect questionnaires. The incidence of chronic pain in our study was 25%, 7.1% of them had features of neuropathic pain (3 patients met criteria for neuropathic pain according to DN4). Conclusion: Our prospective study suggests a possible favourable impact of intraoperative epidural analgesia and dexme-detomidine infusion on the incidence of chronic postoperative pain.