title: Risk factors for persistent pain after urological surgery.
abstract: OBJECTIVE
  Ten to 50% of patients with post-surgical pain develop chronic pain depending on the type of surgery. The objective of this study was to assess the incidence of persistent post-surgical pain (PPSP) and to identify risk factors following urology surgery.
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  Two hundred and twenty-eight patients scheduled for urology surgery. Reasons for non-inclusions: patients who underwent a procedure not defined as being associated with PPSP.
  
  
  METHODS
  Surgical urologic procedures potentially associated with PPSP were defined. All patients who had one of these procedures during the study period received a questionnaire by mail at least 3 months after the surgery. The files of these patients were retrospectively studied.
  
  
  RESULTS
  Eight percent of the patients had preoperative pain. PPSP, assessed approximately 6 months after the surgery, was reported by 24% of the patients. Twenty-five (36%) of them reported neuropathic pain. Patients with PPSP had significantly more preoperative pain and an increased postoperative morphine consumption. Postoperative NSAID administration led to less persistent pain. Multivariate logistic regression analysis identified two independent risk factors of developing persistent pain: preoperative pain (OR=21.6, 95% CI 6.7-69.5, P<0.0001), morphine consumption 48 hours after surgery higher than 6mg (OR=2.3, 95% CI 1.2-4.3, P=0.0118).
  
  
  CONCLUSIONS
  These findings confirm the role of preoperative pain and morphine consumption in the genesis of PPSP and call for establishing clinical perioperative pathways tailored to the patient.
authors.affiliation: Service anesthésie-réanimation, CHU de Rennes, 35033 Rennes, France.
authors.forename: M
authors.initials: M
authors.lastname: Artus
authors.affiliation: Inserm, service de pharmacologie clinique, CIC-P 0203 centre d'investigation clinique, université de Rennes 1, CHU de Rennes, 35033 Rennes, France.
authors.forename: B
authors.initials: B
authors.lastname: Laviolle
authors.affiliation: Service anesthésie-réanimation, CHU de Rennes, 35033 Rennes, France.
authors.forename: A
authors.initials: A
authors.lastname: Maurice
authors.affiliation: Service anesthésie-réanimation, CHU de Rennes, 35033 Rennes, France; Inserm UMR 991, 35033 Rennes, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Malledant
authors.affiliation: Service anesthésie-réanimation, CHU de Rennes, 35033 Rennes, France; Inserm UMR 991, 35033 Rennes, France. Electronic address: helene.beloeil@chu-rennes.fr.
authors.forename: H
authors.initials: H
authors.lastname: Beloeil
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013520:Urologic Surgical Procedures / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine
keywords: Chronic; Chronic post-surgical pain; Chronique; Douleur; Douleur chronique postchirurgicale; Morphine; Pain; Persistent; Urologie; Urology