title: Persistent postsurgical pain in a general population: prevalence and predictors in the Tromsø study.
abstract: Population-based data on the prevalence of persistent postsurgical pain are scarce. This study aimed to assess the prevalence of persistent postsurgical pain in a general population and to describe associated physical, social, and psychological factors, including symptoms of nerve injury and sensitization. A cross-sectional survey was performed in northern Norway with questionnaire items covering surgery, pain, and sensory abnormalities in the area of surgery. Of the 12,982 participants, 24.0% (3111) had undergone one or more surgical procedures during the 3 years preceding the survey. Of these, 2043 had the surgery performed more than 3 months before the investigation. Persistent pain in the area of surgery was reported by 40.4% of the patients (826 of 2043), moderate or severe pain by 18.3% (373 of 2043). Hypoesthesia, hyperesthesia, or both was reported by 24.5% (501 of 2043). There were strong associations between sensory abnormalities and persistent pain, increasingly with higher pain intensities; odds ratios were 2.68 for hypoesthesia and 6.27 for hyperesthesia. Of the 826 individuals reporting persistent pain in the anatomical area of surgery, 51.0% reported chronic pain when questioned without specific reference to the surgery. The present study supports evidence from clinical studies of persistent postsurgical pain, indicating a high prevalence, but reveals large discrepancies in report of pain, depending on the questions asked and the context in which the questions are presented. Strong associations between sensory abnormalities and pain indicate neuropathic mechanisms in a major proportion of cases.
authors.affiliation: Division of Surgical Medicine and Intensive Care, University Hospital of North Norway, Tromsø, Norway Division of Emergencies and Critical Care, Oslo University Hospital, Rikshospitalet, Oslo, Norway Department of Mental Health, Norwegian Institute of Public Health, Oslo, Norway Department of Clinical Medicine, University of Tromsø, Tromsø, Norway Department of Pain Management and Research, Oslo University Hospital and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway.
authors.forename: Aslak
authors.initials: A
authors.lastname: Johansen
authors.forename: Luis
authors.initials: L
authors.lastname: Romundstad
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Nielsen
authors.forename: Henrik
authors.initials: H
authors.lastname: Schirmer
authors.forename: Audun
authors.initials: A
authors.lastname: Stubhaug
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires