• Eur J Anaesthesiol · Oct 2015

    Chronic postsurgical pain after laparoscopic colorectal surgery: A retrospective analysis of its prevalence, characteristics and risk factors.

    • Jean L Joris, Mathieu J Georges, Kamel Medjahed, Didier Ledoux, Gaëlle Damilot, Caroline C Ramquet, Carla I Coimbra, Laurent P Kohnen, and Jean François E Brichant.
    • From the Department of Anaesthesiology and Intensive Care Medicine (JLJ, MJG, KM, DL, GD, CCR, JFEB), and Department of Abdominal Surgery and Transplantation, CHU of Liege, University of Liege, Liege, Belgium (CIC, LPK).
    • Eur J Anaesthesiol. 2015 Oct 1; 32 (10): 712-7.

    BackgroundThe 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.ObjectiveThe aim of the study was to determine the prevalence, the characteristics and the risk factors for CPSP after laparoscopic colorectal surgery.DesignA retrospective analysis using a postal questionnaire.SettingThe study was conducted at a university teaching hospital.PatientsPatients who underwent laparoscopic colorectal surgery from April 2008 until December 2011 (n = 260). No epidural analgesia was used.Main Outcome MeasuresPostoperative pain intensity, incidence and characteristics of CPSP, and impact on quality of life and sleep.ResultsOf 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).ConclusionThe 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.Trial RegistrationEudraCT 2012-005712-25.

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