A survey of patients' understanding and expectations of persistent postsurgical pain in a preoperative testing center.
OBJECTIVE
Acute postoperative pain may transition to persistent/chronic pain in up to 50% or more of patients after certain surgeries. Despite this concern, it is unclear that patients' preprocedure understanding and expectations are aligned with these potential outcomes. This study was designed to evaluate the extent of this alignment and the potential impact on the quality of risk/benefit discussions before procedures.


METHODS
Prospective survey.


METHODS
A large, tertiary care preoperative assessment clinic.


METHODS
A total of 1481 adult patients.


METHODS
Survey administration.


METHODS
The survey items evaluated patients' expectations of postoperative pain and how familiar patients were with the risk of persistent postsurgical pain based on their specific characteristics and procedure type.


RESULTS
The overwhelming majority (80%) of patients were unaware of the risk of persistent postsurgical pain. Given the choice, most patients (65%) wanted to be informed of their risk, and 25% stated that it might even affect their decision to proceed with surgery.


CONCLUSIONS
There is great need for health care providers to discuss the significant risk of persistent postsurgical pain with patients in the preoperative setting. Patients need to be armed with realistic data to ensure high-quality discussions of risk/benefit, align expectations with outcomes, and potentially identify high-risk groups in which preoperative intervention can reduce the likelihood or severity of persistent postoperative pain syndromes.
Department of Anesthesiology, Brigham and Women's Hospital, Boston, MA, USA. Electronic address: jenniferol@pcom.edu.
Jennifer B
JB
Oliver
North Shore Medical Center, Salem, MA, USA.
Kiana
K
Kashef
Harvard Medical School, Boston, MA, USA.
Angela M
AM
Bader
Harvard Medical School, Boston, MA, USA.
Darin J
DJ
Correll
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059350:Chronic Pain / Q000523:psychology*; D032882:Comprehension; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000523:psychology*; D010817:Physician-Patient Relations; D011300:Preoperative Care; D011446:Prospective Studies; D018570:Risk Assessment; D013514:Surgical Procedures, Operative / Q000009:adverse effects; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers
Informed consent; Postoperative pain; Postsurgical pain; Preoperative clinic; Survey