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Licensed Unlicensed Requires Authentication Published by De Gruyter July 1, 2012

Systematic review of neuropathic component in persistent post-surgical pain

  • S. Haroutiunian , L. Nikolajsen , N.B. Finnerup and T.S. Jensen



The aim of the current study was to assess the neuropathic component of persistent post-surgical pain (PPSP) following eleven types of surgery.


We performed a systematic PubMed, CENTRAL and EMBASE search to identify studies on PPSP following (i) thoracic surgery, (ii) breast surgery, (iii) groin hernia repair, (iv) prostatectomy, (v) major abdominal surgery, (vi) gynecologic surgery, (vii) iliac crest bone harvest, (viii) total hip arthroplasty (THA) or knee arthroplasty (TKA), (ix) varicose vein stripping or ablation, (x) mandibular sagittal split osteotomy and (xi) donor nephrectomy, and assessed the prevalence of Probable/Definite neuropathic pain using the recently published neuropathic pain probability grading criteria [1].


We included 291 relevant papers. Surgeries performed in the thoracic/breast area resulted in similarly high median PPSP prevalence of about 30–35%; bone and joint surgeries resulted in similar PPSP prevalence of about 20%; and surgeries on visceral organs resulted in lower PPSP prevalence of 10–14%. The reported ranges of PPSP prevalence were very wide, between 0 and 91%. The prevalence of Probable/Definite neuropathic pain among patients with PPSP was about 65% after thoracic and breast surgeries, about 32% after groin hernia repair and gynecologic surgery, and between 9 and 16% after bone and joint surgeries such as iliac crest bone harvest and THA/TKA. In varicose vein surgeries and mandibular sagittal split osteotomies more research is needed to investigate the contribution of neuropathic pain mechanisms.


PPSP after different surgeries is reported to be common and often neuropathic. This systematic review of the literature showed that reported PPSP prevalences range widely among studies, and only a minority of studies used methodology that enabled the estimation of Probable/Definite neuropathic pain prevalence.


[1] Treede RD, Jensen TS, Campbell JN, et al. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 2008;70:1630–5.10.1212/01.wnl.0000282763.29778.59Search in Google Scholar PubMed

Published Online: 2012-07-01
Published in Print: 2012-07-01

© 2012 Scandinavian Association for the Study of Pain

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