Persistent Post-Surgical Pain: Preoperative Predictors and the Consultation Where They Could Be Discussed
DOI:
https://doi.org/10.5281/zenodo.22548311Keywords:
Persistent post-surgical pain, Chronic post-surgical pain, Preoperative assessment, Pain predictors, Transitional pain serviceAbstract
Persistent post-surgical pain (PPSP) affects a substantial minority of patients after almost every category
of major surgery, from around one in ten after inguinal herniorrhaphy to more than half after limb
amputation, yet the preoperative consultation that precedes every one of these operations rarely includes
a structured discussion of the individual patient's risk. A substantial predictor literature has accumulated
-- higher-intensity preoperative pain, psychological distress, nerve-injury-prone surgical technique,
younger age, and genetic and family pain history all show independent association with PPSP across
multiple surgical populations -- but that evidence has been slow to translate into routine preoperative
screening. This review synthesises the predictor literature and the emerging risk-stratification and
transitional pain service models built on top of it, and asks what a preoperative consultation that actually
used this evidence would look like.
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