Journal
PAIN
Volume 155, Issue 11, Pages 2400-2407Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.pain.2014.09.019
Keywords
Postcholecystectomy pain; Postcholecystectomy syndrome; Chronic postsurgery pain; Visceral pain; Referred pain
Categories
Funding
- Region of Southern Denmark
- Udviklingsradet Vejle Hospital
- DASAIM's forskningsinitiativ
- Fabrikant Mads Clausens Fond
- Else Poulsens Mindelegat
- Oberstinde Kirsten Jensa la Cours Legat
- Laege Frk. K. Rasmussens Mindelegat
- Legat stiftet af Foreningen Bikuben
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Chronic pain after laparoscopic cholecystectomy is related to postoperative pain during the first postoperative week, but it is unknown which components of the early pain response is important. In this prospective study, 100 consecutive patients were examined preoperatively, 1 week postoperatively, and 3, 6, and 12 months postoperatively for pain, psychological factors, and signs of hypersensitivity. Overall pain, incisional pain (somatic pain component), deep abdominal pain (visceral pain component), and shoulder pain (referred pain component) were registered on a 100-mm visual analogue scale during the first postoperative week. Nine patients developed chronic unexplained pain 12 months postoperatively. In a multivariate analysis model, cumulated visceral pain during the first week and number of preoperative biliary pain attacks were identified as independent risk factors for unexplained chronic pain 12 months postoperatively. There were no consistent signs of hypersensitivity in the referred pain area either pre- or postoperatively. There were no significant associations to any other variables examined. The risk of chronic pain after laparoscopic cholecystectomy is relatively low, but significantly related to the visceral pain response during the first postoperative week. (C) 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
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