Pain, function, and acute neuropathic pain up to one month after surgery: a registry-based analysis.
Publisher DOI
PubMed ID
42326991
Abstract
Introduction
Knowledge of how patients experience pain and patterns of resolution beyond the first days after surgery is limited. Acute neuropathic pain (ANeuP) following surgery is rarely assessed.Objectives
We aimed to characterize pain intensity, pain-related functional impairment, ANeuP, and to describe patterns of resolution in a large cohort undergoing diverse surgical procedures up to 1 month postoperatively, the subacute period.Methods
This was an observational, multicentre study. Outcomes were assessed on postoperative days (PODs) 1/7/30 using the PAIN OUT registry methodology. The primary endpoint was the change in pain-related interference between POD7 and POD30. Patient subgroups were identified using cluster analysis.Results
A cohort of 1,153 patients (median age 49; 67% female) was enrolled. By POD30, pain-related functional interference decreased (P < 0.001, moderate-to-large effect). The cluster analysis identified 3 subgroups: Minimal-pain resolution (16% of the cohort), Slow-pain resolution (30.5%), and Fast-pain resolution (53.5%). By POD30, patients in the Slow- and Fast-pain resolution clusters had largely recovered, differing in recovery rate. Those in the Minimal-pain resolution cluster showed limited improvement from POD1. By POD30, these patients still experienced mild-moderate pain and interference, with 40% screening positive for ANeuP and 24% taking opioids. Risk factors included chronic preexisting pain and thoracic or orthopaedic surgery.Conclusion
Although the majority of patients in the cohort largely recovered in terms of pain and interference by POD30, 16% belonged to the Minimal-pain resolution cluster. These patients may benefit from proactive identification and management by anaesthetists, surgeons, and practitioners in the community before surgery or in the early weeks after surgery.
Knowledge of how patients experience pain and patterns of resolution beyond the first days after surgery is limited. Acute neuropathic pain (ANeuP) following surgery is rarely assessed.Objectives
We aimed to characterize pain intensity, pain-related functional impairment, ANeuP, and to describe patterns of resolution in a large cohort undergoing diverse surgical procedures up to 1 month postoperatively, the subacute period.Methods
This was an observational, multicentre study. Outcomes were assessed on postoperative days (PODs) 1/7/30 using the PAIN OUT registry methodology. The primary endpoint was the change in pain-related interference between POD7 and POD30. Patient subgroups were identified using cluster analysis.Results
A cohort of 1,153 patients (median age 49; 67% female) was enrolled. By POD30, pain-related functional interference decreased (P < 0.001, moderate-to-large effect). The cluster analysis identified 3 subgroups: Minimal-pain resolution (16% of the cohort), Slow-pain resolution (30.5%), and Fast-pain resolution (53.5%). By POD30, patients in the Slow- and Fast-pain resolution clusters had largely recovered, differing in recovery rate. Those in the Minimal-pain resolution cluster showed limited improvement from POD1. By POD30, these patients still experienced mild-moderate pain and interference, with 40% screening positive for ANeuP and 24% taking opioids. Risk factors included chronic preexisting pain and thoracic or orthopaedic surgery.Conclusion
Although the majority of patients in the cohort largely recovered in terms of pain and interference by POD30, 16% belonged to the Minimal-pain resolution cluster. These patients may benefit from proactive identification and management by anaesthetists, surgeons, and practitioners in the community before surgery or in the early weeks after surgery.
Date Issued
2026-08
Publication Type
Article
Subject(s)
Subjects
Acute neuropathic pain
•
Postoperative pain
•
Recovery
•
Risk factors
•
Subacute pain
•
Surgery
Language(s)
en
Author(s)
Garduño-López, Ana Lilia | |
Baumbach, Philipp | |
Acosta-Nava, Victor Manuel | |
Verdugo-Velázquez, Frida Fernanda | |
Vidaña-Martínez, Gabriela Josefina | |
Molina-Niño, Eldeli | |
Cuellar-Gúzman, Luis Felipe | |
García-Herrera, Belén Aurora | |
Rascón-Martínez, Dulce María | |
Islas-Lagunas, Gabriela | |
Pineda-Pérez, Juan de la Cruz | |
Cano-García, J Jesús | |
Calderon-Vidal, Mariana | |
Jimenez-Tornero, Jorge | |
López-Hernández, Oscar | |
Villegas-Sotelo, Elizabeth | |
Dominguez-Cid, Monica | |
Flores-Villanueva, Maria Esther | |
Meissner, Winfried | |
Komann, Marcus | |
Weinmann, Claudia | |
Zaslansky, Ruth |
Additional Credits
Journal
PAIN Reports
Publisher
Lippincott, Williams & Wilkins
ISSN
2471-2531
Access(Rights)
open.access