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Post-operative pain: all you need to know about post-operative care

January 04, 2023

A surgical procedure is inherently unpleasant and can cause pain during and after the operation. It is possible to dichotomize this nosological entity into acute postoperative pain and chronic postoperative pain.

Acute postoperative pain is present immediately after the operation, caused by lesions induced by surgery (section and dissection of the skin or muscles, gas administered during laparoscopy, etc.) and by anesthesia (implementation place of the oro-tracheal intubation tube, catheter). It is therefore essentially the result of organ damage by an inflammatory process (cascade of inflammation mediators triggered by surgical stress) which leads to an excess of nociception (reaction of sensory receptors). To a lesser degree, it may be neuropathic or mixed.

Chronic postoperative pain persists long after surgery. It is frequent and would interest more than 40% of patients after an operation. Among these 40%, almost half of the patients describe moderate to severe pain [1].

Chronic postoperative pain depends on several criteria [2] what are :

  • the presence of preoperative pain at the site concerned;

  • the presence of chronic preoperative pain;

  • the presence of a depressive syndrome / burnout in the previous 6 months;

  • the presence of risk factors (stress, sleep disorder, anxiety, catastrophism, long-term opiate consumption, etc.);

  • the intensity of postoperative pain;

  • the patient's feelings about his recovery after the operation.

Thus, the greater the number of criteria, the greater the patient's risk of developing chronic pain. For example, a patient who possesses 3 of these criteria would have a 68% risk of developing chronic postoperative pain.

In addition, chronic pain also depends on the invasive nature of the surgery, the duration of the surgery, the treatment of the acute pain and the sex (the patients are mainly affected). Chronic pain is often mixed with neuropathic and nociceptive components.

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