205: Persistent Post-Surgical Pain Burden in Chronic Pain OPD: Retrospective Analysis From an Onco-Centre

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic postsurgical pain, Epidemiology

Background and Aims: Persistent post-surgical pain (PPSP)can impact quality of life 1. Onco-surgeries are known to be associated with PPSP (2-4). Our hospital is a tertiary onco-centre. The primary aim of this study was to ascertain the percentage of patients presenting to the pain clinic with post-surgical pain. In addition we wanted to assess the severity of pain, to compare the known pre-operative, intra-operative and post-operative risk factors associated with potential transition to PPSP and identify the sub group of oncological surgeries that are more prone to PPSP.

Methods: This study was a retrospective analysis of prospectively collected data from patients who presented with to Pain OPD between 1 January 2022 and 31 December 2024. Institutional approval was obtained prior to data collection. All adult patients presenting to pain OPD with pain at surgical site were included. We excluded patients with disease recurrence, incomplete surgical resection of tumor, surgical complications at presentation, pain at any site other than surgical site/dermatome related. Data analysis was conducted with SPPS software (IBM, version 26).

Results: In three years, 123 patients out of 9796 presented to the OPD with PPSP (0.012%). Head and Neck patients made up the largest group of patients presenting, consisting of 32.5% of the total. Followed by Gastro-Intestinal, Bone and soft tissue (BST) and Thoracic patients. Severity of pain (NRS) was significantly associated with average pain at discharge (p<0.001). Thoracic patients presented with the highest pain scores. Gender, nerve handling intraoperative and perioperative analgesic technique did not influence PPSP.

Conclusions: In our institute, PPSP represents a small proportion of patients attending the pain OPD. There remains a high possibility of under reporting and hence the need for prospective follow-up post surgery especially for selective disease management groups like head neck and thoracic as highlighted in the results.

References: 1. Fuller AM, Bharde S, Sikandar S. The mechanisms and management of persistent postsurgical pain. Frontiers in Pain Research. 2023 Jul 6;4:1154597.
2. Maloney J, Wie C, Pew S, Covington S, Maita M, Kozinn R, Sabin M, Freeman J, Kraus M, Strand N. Post-thoracotomy pain syndrome. Current Pain and Headache Reports. 2022 Sep;26(9):677-81.
3. Chang PJ, Asher A, Smith SR. A targeted approach to post-mastectomy pain and persistent pain following breast cancer treatment. Cancers. 2021 Oct 16;13(20):5191
4. Ramadan MI, Khudair HYA, Obaid AT, Yousef OA, Sammour RA. Prevalence of Chronic Postsurgical Pain among Cancer Patients: A Cross-Sectional Study. Anesth Essays Res. 2022 Jan-Mar;16(1):71-79. doi: 10.4103/aer.aer_24_22. Epub 2022 Jun 27. PMID: 36249138; PMCID: PMC9558672

Presenting Author: DR SUMITRA G BAKSHI
Submitting Author: Sumitra Bakshi

Senior Author: DR APARNA S CHATTERJEE

IASP 2026 Global Year theme of Neuropathic Pain: No

• DR NAGA SAILAJA: MD - Tata Memorial Hospital and Homi Bhabha National Institute
• DR APARNA SANJAY CHATTERJEE: MD - Tata Memorial Hospital and Homi Bhabha National Institute
• DR SHEETAL GAIKWAD: MD - Tata Memorial Hospital and Homi Bhabha National Institute
• DR DEBASHREE LAHIRI: MD - Tata Memorial Hospital and Homi Bhabha National Institute