THE INCIDENCE OF CHRONIC POSTOPERATIVE PAIN AND ITS RISK FACTORS: A SYSTEMATIC REVIEW

Abstract

Background: Chronic postoperative pain (CPP) is the most frequent consequence of surgeries with big impact on the equality of life of the patient. The aim of this study is to analyze and summarize the incidence of chronic pain, its risk factors and interventions after surgery. Methods: The systematic review was conducted using PubMed, Medline and Cochrane Library databases for the systematic reviews and meta-analysis that focused on chronic postoperative pain in adult patients in any type of surgery before April 2025. Results: 54 articles were analyzed. Narrative review was conducted to report the risk factors of chronic postoperative pain and interventions methods. The incidence of CPP at 3 to 6 months after surgery was reported depending on the surgery type: Inguinal hernia repair (5-60%), thoracotomy (38-57%), Cesarean section (4-42%), Breast surgery (50%), knee arthroplasty (20%), cardiac surgery (37%), abdominal surgery (20-30%). The most common patient related risk factors are perioperative pain level, female sex and younger age. The psychological factors like preoperative anxiety, depression and catastrophizing can be considered as predictors of CPP. Conclusion: The most common risk factors of CPP are preoperative pain, female sex, younger age, acute postoperative pain and psychological state of the patient. Inguinal hernia repair surgery has the highest rate of persistent postsurgical pain incidence at 5-60%. Multimodal analgesia is the most recommended and effective method to manage CPP. There is a need for more research towards non-pharmacological treatment methods, particularly focusing on psychological interventions.