Prevalence of acute neuropathic pain after cancer surgery: A prospective study

Indian J Anaesth. 2014 Jan;58(1):36-42. doi: 10.4103/0019-5049.126788.

Abstract

Background and aims: Acute neuropathic pain (ANP) is an under-recognised and under-diagnosed condition and often difficult to treat. If left untreated, it may further transform into persistent post-operative chronic pain leading to a disability.

Aims: This prospective study was undertaken on 300 patients to identify the prevalence of ANP in the post-operative period by using a neuropathic pain detection questionnaire tool.

Methods: This is an open-label study in which patients with six different types of cancer surgeries (Thoracic, gastro-intestinal, gynae/urology, bone/soft-tissue, head and neck and breast subgroups-50 each) were included for painDETECT questionnaire tool on the 2(nd) and 7(th) day surgery.

Results: This study found a 10% point prevalence of ANP. Analysis showed that 25 patients had 'possible' ANP, the maximum from urological cancer surgery (6) followed by thoracic surgery (5). Five patients were found to have 'positive' ANP including 2 groin node dissection, 2 hemipelvectomy and 1 oesophagectomy.

Conclusion: Significant relationship between severity of post-operative pain was found with the occurrence of ANP in the post-operative period requiring a special attention to neuropathic pain assessment. Larger studies are required with longer follow-up to identify accurately the true prevalence and causative factors of ANP after surgery.

Keywords: Acute neuropathic pain; cancer surgery; post-operative pain; prevalence.