• Melodie Fanay Boko, Ashish K Khanna, Frederick D'Aragon, Jessica Spence, David Conen, Ameen Patel, Sabry Ayad, Duminda N Wijeysundera, Manon Choinière, Daniel I Sessler, Francois Martin Carrier, John Harlock, Josèph S H A Koopman, Madeleine Durand, Naeem Bhojani, Alparslan Turan, Gabrielle Pagé, P J Devereaux, Emmanuelle Duceppe, and VALIANCE Study Collaborators..
• Department of Medicine, Université de Montréal, Montreal, QC, Canada.
• Anesthesiology. 2024 Apr 26.

BackgroundThe amount of same-day surgery has increased markedly worldwide in recent decades, but there remains limited evidence on chronic postsurgical pain in this setting.MethodsWe assessed pain 90 days after ambulatory surgery in an international, multicentre prospective cohort study of patients ≥45 years old with comorbidities or ≥65 years old. Pain was assessed using the Brief Pain Inventory. Chronic postsurgical pain was defined as a change ≥1 in self-rated average pain at the surgical site between baseline and 90 days, and moderate to severe chronic postsurgical pain as a score ≥4 in self-rated average pain at the surgical site at 90 days. Risk factors for chronic postsurgical pain were identified using multivariable logistic regression.ResultsBetween November 2021 and January 2023, a total of 2054 participants were included, and chronic postsurgical pain occurred in 12% of participants, of whom 93.1% had new chronic pain at the surgical site (i.e., participants without pain prior to surgery). Moderate to severe chronic postsurgical pain occurred in 9% of overall participants. Factors associated with chronic postsurgical pain were: active smoking (OR 1.82; 95% CI 1.20 to 2.76), orthopaedic surgery (OR 4.7; 95% CI 2.24 to 9.7), plastic surgery (OR 4.3; 95% CI 1.97 to 9.2), breast surgery (OR 2.74; 95% CI 1.29 to 5.8), vascular surgery (OR 2.71; 95% CI 1.09 to 6.7), and ethnicity (i.e., Hispanic/Latino ethnicity OR 3.41; 95% CI 1.68 to 6.9 and First Nations/Native persons OR 4.0; 95% CI 1.05 to 15.4).ConclusionsPersistent postsurgical pain after same-day surgery is common, usually moderate to severe in nature, and occurs mostly in patients without chronic pain prior to surgery.Copyright © 2024 American Society of Anesthesiologists. All Rights Reserved.

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