517: Post-Surgical Neuropathic Pain in LMIC : A Systematic Review Across Surgical Specialties.

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic neuropathic pain, Assessment and Measurement of Pain/Nociception

Background and Aims: Post-surgical neuropathic pain (PSNP) is a major contributor to chronic post-surgical pain and carries a substantial functional and socioeconomic burden. While its prevalence is well recognized in high-income countries, evidence from low- and middle-income countries (LMICs) remains limited, despite marked disparities in perioperative care, pain assessment capacity, and postoperative follow-up. Understanding PSNP prevalence in LMICs is essential to guide global perioperative practice and address inequities in pain management.

This systematic review aims to determine the prevalence of PSNP across surgical specialties in LMICs and assess whether prevalence estimates differ between studies that utilize validated screening questionnaires versus the NeuPSIG criteria.

Methods: The study protocol has been registered with PROSPERO (ID: CRD420251174160). This systematic review is being conducted in accordance with the PRISMA guidelines and the Cochrane Handbook . A systematic search of PubMed, Scopus, CENTRAL, and clinicaltrials.gov for English-language studies (2011–2026) included from World Bank–defined LMICs. Eligible studies include adults (≥18 years) assessed ≥3 months after surgery, with PSNP identified by NeuPSIG criteria or validated screening tools. Quantitative prevalence-reporting designs are included. exclusion criteria included acute pain pediatric populations, non-surgical pain, or lacking validated neuropathic assessment . Two reviewers independently screen studies, extract data, and appraise risk of bias using JBI Checklist.

Results: A descriptive synthesis will summarize study characteristics, surgical specialties, assessment tools, and reported prevalence. Where appropriate, a random-effects meta-analysis will estimate pooled PSNP prevalence, given anticipated heterogeneity across countries and procedures. Heterogeneity will be assessed using I². Planned subgroup analyses include surgical specialty and neuropathic pain assessment method, with sensitivity analyses excluding high-risk-of-bias studies. Funnel plots will be generated if at least 10 studies are included. Results will be presented as pooled prevalence with 95% confidence and prediction intervals. Additional subgroup analyses will explore study design and geographic region. Statistical significance will be set at p < 0.05.

Conclusions: The detailed results will be presented at the IASP Congress. We believe this review will offer the first comprehensive synthesis of PSNP prevalence in LMICs, identify key methodological and health system gaps, and inform strategies to strengthen postoperative pain assessment and peri-operative pain care capacity worldwide.

References: 1. Schug, Stephan A.a; Lavand'homme, Patriciab; Barke, Antoniac; Korwisi, Beatricec; Rief, Winfriedc; Treede, Rolf-Detlefd,*; The IASP Taskforce for the Classification of Chronic Pain. The IASP classification of chronic pain for ICD-11: chronic postsurgical or posttraumatic pain. PAIN 160(1):p 45-52, January 2019. | DOI: 10.1097/j.pain.0000000000001413
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Presenting Author: Gouhar Afshan
Submitting Author: GOUHAR AFSHAN

Senior Author: Aliya Ahmed

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• Ali Sarfraz Siddiqui: MBBS, FCPS - The Aga Khan University
• Ausaf Khan: MBBS, FCPS - The Aga Khan
• Azhar Rehman: MBBS, FCPS - The Aga Khan University
• Aliya Ahmed: MBBS, FRCA - The aga Khan University
• Fatima Nazir: MSc /MPhil - The Aga Khan University
• Kalimullah Rehman: Phd statistics - The Aga Khan University
• Robyna Khan: MBBs, FCPS - The Aga Khan University
• Faisal Shamim: MBBS, FCPS - The Aga Khan University
• Shemila Abbasi: MBBS, FCPS - The Aga Khan University
• Tanveer Baig: MBBS, FCPS - The Aga Khan University