Is Preoperative Quantitative Sensory Testing Related to Persistent Postsurgical Pain? A Systematic Literature Review

Noud van Helmond*, Hugo M Aarts, Hans Timmerman, Søren S Olesen, Asbjørn M Drewes, Oliver H Wilder-Smith, Monique A Steegers, Kris C Vissers

*Corresponding author for this work

    Research output: Contribution to journalReview articleAcademicpeer-review

    10 Citations (Scopus)
    27 Downloads (Pure)

    Abstract

    Persistent postsurgical pain (PPSP) is a common complication of surgery that significantly affects quality of life. A better understanding of which patients are likely to develop PPSP would help to identify when perioperative and postoperative pain management may require specific attention. Quantitative sensory testing (QST) of a patient's preoperative pain perception is associated with acute postoperative pain, and acute postoperative pain is a risk factor for PPSP. The direct association between preoperative QST and PPSP has not been reviewed to date. In this systematic review, we assessed the relationship of preoperative QST to PPSP. We searched databases with components related to (1) preoperative QST; (2) association testing; and (3) PPSP. Two authors reviewed all titles and abstracts for inclusion. Inclusion criteria were as follows: (1) QST performed before surgery; (2) PPSP assessed >= 3 months postoperatively; and (3) the association between QST measures and PPSP is investigated. The search retrieved 905 articles; 24 studies with 2732 subjects met inclusion criteria. Most studies (22/24) had moderate to high risk of bias in multiple quality domains. Fourteen (58%) studies reported a significant association between preoperative QST and PPSP. Preoperative temporal summation of pain (4 studies), conditioned pain modulation (3 studies), and pressure pain threshold (3 studies) showed the most frequent association with PPSP. The strength of the association between preoperative QST and PPSP varied from weak to strong. Preoperative QST is variably associated with PPSP. Measurements related to central processing of pain may be most consistently associated with PPSP.

    Original languageEnglish
    Pages (from-to)1146-1155
    Number of pages10
    JournalAnesthesia and Analgesia
    Volume131
    Issue number4
    Early online date14-May-2020
    DOIs
    Publication statusPublished - Oct-2020

    Keywords

    • CHRONIC POSTOPERATIVE PAIN
    • TEMPORAL SUMMATION
    • KNEE REPLACEMENT
    • RISK-FACTORS
    • PREDICTION
    • SURGERY
    • SENSITIZATION
    • ASSOCIATION
    • HYSTERECTOMY
    • HYPERALGESIA

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