Chronic postsurgical pain is a common surgical complication that severely reduces a patient’s quality of life.Many perioperative interventions and management strategies have been developed for reducing and managing c...Chronic postsurgical pain is a common surgical complication that severely reduces a patient’s quality of life.Many perioperative interventions and management strategies have been developed for reducing and managing chronic postsurgical pain.Under the leadership of the Chinese Association for the Study of Pain,an editorial committee was formed for chronic postsurgical pain diagnosis and treatment by experts in relevant fields.The editorial committee composed the main content and framework of this consensus and established a working group.The working group conducted literature review(1989-2020)using key words such as“surgery”,“post-surgical”,“post-operative”,“pain”,“chronic”,and“persistent”in different databases including MEDLINE,EMBASE,PubMed,Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews.Only publications in the English language were included.The types of literature included systematic reviews,randomized controlled studies,cohort studies and case reports.This consensus was written based on clinical practice combined with literature evidence.The first draft of the consensus was rigorously reviewed and edited by all the editorial committee experts before being finalized.The level of evidence was assessed by methodological experts based on the Oxford Centre for Evidence-Based Medicine Levels of Evidence.The strength of recommendation was evaluated by all editorial committee experts,and the opinions of most experts were adopted as the final decision.The recommendation level“strong”generally refers to recommendations based on high-level evidence and consistency between clinical behavior and expected results.The recommendation level“weak”generally refers to the uncertainty between clinical behavior and expected results based on low-level evidence.展开更多
Chronic postsurgical pain (CPSP) following gastrointestinal (GI) surgery is acommon issue that poses significant challenges to patients’ recovery and qualityof life. Given the importance of vitamin D in inflammation ...Chronic postsurgical pain (CPSP) following gastrointestinal (GI) surgery is acommon issue that poses significant challenges to patients’ recovery and qualityof life. Given the importance of vitamin D in inflammation reduction, nerverepair, bone health, and immune regulation, its potential role in pain managementhas gained increasing attention. Preliminary evidence suggests that many patientswho undergo GI surgery have lower perioperative vitamin D levels. Patients withvitamin D deficiency have increased opioid use and heightened pain sensitivityafter colorectal cancer surgery. Patients with lower vitamin D levels experiencegreater pain three months after arthroscopic rotator cuff repair or video-assistedthoracoscopic surgery. However, research on the relationship between vitamin Dand CPSP after GI surgery is limited. Larger, well-designed clinical trials areneeded to determine the causal relationship between low vitamin D levels andCPSP, determine the optimal perioperative vitamin D levels, and provide morereliable evidence for clinical application. Moreover, vitamin D has positive effectson various systemic diseases and postoperative recovery, including immuneregulation, infection prevention, wound healing, tissue regeneration, nutritionalstatus, and metabolic health. These findings indicate that vitamin D has broadclinical application potential. We hope to provide a new insight into postoperativerecovery and pain management strategies for GI surgeries.展开更多
<b>Background:</b> Persistent post-surgical pain (PPSP) is pain that lasts for 3 months or more after a surgical intervention, where other causes of pain have been excluded. There is scarce knowledge about...<b>Background:</b> Persistent post-surgical pain (PPSP) is pain that lasts for 3 months or more after a surgical intervention, where other causes of pain have been excluded. There is scarce knowledge about the prevalence of PPSP in low- and middle-income countries (LMICs). The aim of our study was to assess the prevalence of PPSP after total knee arthroplasty (TKA) at our university hospital and explore factors associated with it. <b>Methods:</b> It was a prospective cross-sectional study. Approval was obtained from the Ethics Review Committee. Patients undergoing elective unilateral total knee arthroplasty under general or regional anaesthesia were recruited over a six months period. A designated pain nurse called the patients three months after surgery and asked about the presence of pain, its location, type, degree and associated factors. Patients who reported pain at three months were called a year after the surgery and the same questions were asked. <b>Results:</b> Eighty-two patients had TKA during the study period. At the time of discharge, 57 (69.5%) patients were satisfied with their postoperative pain management. Three months after the surgery, 13 (15.8%) patients reported pain. Pain was mild in 11 and moderate in two patients. At one-year follow-up, three patients (3.6%) reported pain that was mild to moderate in intensity. Pain disturbed sleep in all three patients and disturbed daily life routines in one patient. No significant difference was found in any of the variables when compared with patients who did not report pain at three months. <b>Conclusions:</b> Although PPSP is a recognized adverse outcome after TKA, little is known about its prevalence in LMICs. In our patient population, 15.8% reported pain three months after TKA, while at one year, 3.6% of patients reported mild to moderate pain. Multicenter studies are recommended for determining the overall prevalence in our patient population and for getting directions for making targeted efforts towards its prevention and treatment.展开更多
文摘Chronic postsurgical pain is a common surgical complication that severely reduces a patient’s quality of life.Many perioperative interventions and management strategies have been developed for reducing and managing chronic postsurgical pain.Under the leadership of the Chinese Association for the Study of Pain,an editorial committee was formed for chronic postsurgical pain diagnosis and treatment by experts in relevant fields.The editorial committee composed the main content and framework of this consensus and established a working group.The working group conducted literature review(1989-2020)using key words such as“surgery”,“post-surgical”,“post-operative”,“pain”,“chronic”,and“persistent”in different databases including MEDLINE,EMBASE,PubMed,Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews.Only publications in the English language were included.The types of literature included systematic reviews,randomized controlled studies,cohort studies and case reports.This consensus was written based on clinical practice combined with literature evidence.The first draft of the consensus was rigorously reviewed and edited by all the editorial committee experts before being finalized.The level of evidence was assessed by methodological experts based on the Oxford Centre for Evidence-Based Medicine Levels of Evidence.The strength of recommendation was evaluated by all editorial committee experts,and the opinions of most experts were adopted as the final decision.The recommendation level“strong”generally refers to recommendations based on high-level evidence and consistency between clinical behavior and expected results.The recommendation level“weak”generally refers to the uncertainty between clinical behavior and expected results based on low-level evidence.
文摘Chronic postsurgical pain (CPSP) following gastrointestinal (GI) surgery is acommon issue that poses significant challenges to patients’ recovery and qualityof life. Given the importance of vitamin D in inflammation reduction, nerverepair, bone health, and immune regulation, its potential role in pain managementhas gained increasing attention. Preliminary evidence suggests that many patientswho undergo GI surgery have lower perioperative vitamin D levels. Patients withvitamin D deficiency have increased opioid use and heightened pain sensitivityafter colorectal cancer surgery. Patients with lower vitamin D levels experiencegreater pain three months after arthroscopic rotator cuff repair or video-assistedthoracoscopic surgery. However, research on the relationship between vitamin Dand CPSP after GI surgery is limited. Larger, well-designed clinical trials areneeded to determine the causal relationship between low vitamin D levels andCPSP, determine the optimal perioperative vitamin D levels, and provide morereliable evidence for clinical application. Moreover, vitamin D has positive effectson various systemic diseases and postoperative recovery, including immuneregulation, infection prevention, wound healing, tissue regeneration, nutritionalstatus, and metabolic health. These findings indicate that vitamin D has broadclinical application potential. We hope to provide a new insight into postoperativerecovery and pain management strategies for GI surgeries.
文摘<b>Background:</b> Persistent post-surgical pain (PPSP) is pain that lasts for 3 months or more after a surgical intervention, where other causes of pain have been excluded. There is scarce knowledge about the prevalence of PPSP in low- and middle-income countries (LMICs). The aim of our study was to assess the prevalence of PPSP after total knee arthroplasty (TKA) at our university hospital and explore factors associated with it. <b>Methods:</b> It was a prospective cross-sectional study. Approval was obtained from the Ethics Review Committee. Patients undergoing elective unilateral total knee arthroplasty under general or regional anaesthesia were recruited over a six months period. A designated pain nurse called the patients three months after surgery and asked about the presence of pain, its location, type, degree and associated factors. Patients who reported pain at three months were called a year after the surgery and the same questions were asked. <b>Results:</b> Eighty-two patients had TKA during the study period. At the time of discharge, 57 (69.5%) patients were satisfied with their postoperative pain management. Three months after the surgery, 13 (15.8%) patients reported pain. Pain was mild in 11 and moderate in two patients. At one-year follow-up, three patients (3.6%) reported pain that was mild to moderate in intensity. Pain disturbed sleep in all three patients and disturbed daily life routines in one patient. No significant difference was found in any of the variables when compared with patients who did not report pain at three months. <b>Conclusions:</b> Although PPSP is a recognized adverse outcome after TKA, little is known about its prevalence in LMICs. In our patient population, 15.8% reported pain three months after TKA, while at one year, 3.6% of patients reported mild to moderate pain. Multicenter studies are recommended for determining the overall prevalence in our patient population and for getting directions for making targeted efforts towards its prevention and treatment.
