Prevalence studies of chronic pain of postoperative origin in a geriatric ward.

The aim of this study is to estimate the prevalence of chronic pain of postoperative origin in an elderly population hospitalized in a geriatric ward.
To do this 100 consecutive patients hospitalized in the department will be examined by the geriatric doctors.
Patients, after questioning (when possible), will undergo a full physical examination looking for an abnormally painful surgical scar. This examination is carried out by the rolled pinch maneuver. The patient is considered to be chronically painful if this maneuver causes unusual pain.

Patient characteristics:

The average age of the patients is 85.6 years (+/- 7.8 years).
There are 68% women and 32% men.
The prevalence of dementia is 39% (MMS)

Prevalence

There are 12% of patients meeting the criteria of this study.
6% of hospitalized patients were directly related to this problem of chronic postoperative pain.

6 Patients benefited from a scar injection of 1% lidocaine. Of these 6 patients, 5 were totally or partially relieved for a period not evaluated in this study.

Discussion.

The prevalence of chronic pain in the population is estimated to be around 20%. Chronic postoperative pain is neuropathic pain. It is estimated that operated patients will develop this type of pain with a frequency between 5 and 30%. The proportion of neuropathic pain in chronic pain is between 17 and 25% of patients which should make us in the general population an incidence of approximately 5% of neuropathic pain.
In this study, we should therefore find an incidence of postoperative pain much lower than the figures found (12%).

Conclusion

The incidence of postoperative neuropathic pain is totally underestimated. Their diagnostic method, which is exclusively clinical, is not or poorly understood. A study with a larger cohort would be necessary to clarify things.

Author: Dr CAMMAS Sophie, Dr GUENARD Yves