Expert Consensus
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2021; 9(9): 2090-2099
Published online Mar 26, 2021. doi: 10.12998/wjcc.v9.i9.2090
Chinese Association for the Study of Pain: Expert consensus on chronic postsurgical pain
Yi-Ming Liu, Yi Feng, Yan-Qing Liu, Yan Lv, Yuan-Chang Xiong, Ke Ma, Xian-Wei Zhang, Jin-Feng Liu, Yi Jin, Hong-Guang Bao, Min Yan, Tao Song, Qing Liu
Yi-Ming Liu, Yi Feng, Department of Algology, Peking University People’s Hospital, Beijing 100044, China
Yan-Qing Liu, Department of Algology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
Yan Lv, Department of Algology, Air Force Medical University of PLA, Xi’an 710032, Shaanxi Province, China
Yuan-Chang Xiong, Department of Anesthesiology, Changhai Hospital, Naval Military Medical University, Shanghai 200433, China
Ke Ma, Department of Algology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
Xian-Wei Zhang, Department of Anesthesiology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Jin-Feng Liu, Department of Algology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Yi Jin, Department of Algology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
Hong-Guang Bao, Department of Anesthesiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China
Min Yan, Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University school of Medicine, Hangzhou 310058, Zhejiang Province, China
Tao Song, Department of Algology, The First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Qing Liu, Department of Algology, The Affiliated T.C.M Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Author contributions: Liu YM and Feng Y wrote the manuscript; Liu YM, Feng Y, Liu YQ, Lv Y, Xiong YC, Ma K, Zhang XW, Liu JF, Jin Y, Bao HG, Yan M, Song T and Liu Q collected and analyzed the data; All authors have read and approve the final manuscript.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi Feng, MD, Director, Professor, Department of Algology, Peking University People’s Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing 100044, China. doctor_yifeng@sina.com
Received: December 25, 2020
Peer-review started: December 25, 2020
First decision: January 10, 2021
Revised: January 15, 2021
Accepted: March 9, 2021
Article in press: March 9, 2021
Published online: March 26, 2021
Processing time: 90 Days and 18.1 Hours
Abstract

Chronic postsurgical pain is a common surgical complication that severely reduces a patient’s quality of life. Many perioperative interventions and management strategies have been developed for reducing and managing chronic postsurgical pain. Under the leadership of the Chinese Association for the Study of Pain, an editorial committee was formed for chronic postsurgical pain diagnosis and treatment by experts in relevant fields. The editorial committee composed the main content and framework of this consensus and established a working group. The working group conducted literature review (1989-2020) using key words such as “surgery”, “post-surgical”, “post-operative”, “pain”, “chronic”, and “persistent” in different databases including MEDLINE, EMBASE, PubMed, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews. Only publications in the English language were included. The types of literature included systematic reviews, randomized controlled studies, cohort studies and case reports. This consensus was written based on clinical practice combined with literature evidence. The first draft of the consensus was rigorously reviewed and edited by all the editorial committee experts before being finalized. The level of evidence was assessed by methodological experts based on the Oxford Centre for Evidence-Based Medicine Levels of Evidence. The strength of recommendation was evaluated by all editorial committee experts, and the opinions of most experts were adopted as the final decision. The recommendation level “strong” generally refers to recommendations based on high-level evidence and consistency between clinical behavior and expected results. The recommendation level “weak” generally refers to the uncertainty between clinical behavior and expected results based on low-level evidence.

Keywords: Chronic postsurgical pain; Treatment; Interventional; Prevention

Core Tip: Chronic post-surgical pain (CPSP) is a common surgical complication. An editorial committee of experts in relevant fields was organized by the Chinese Association for the Study of Pain to draft this expert consensus. This expert consensus includes the definition, risk factors, pathogenesis, clinical manifestations, treatment and prevention of CPSP. It describes various treatments of CPSP with their associated recommendation levels, based on the clinical practice and literature references. This consensus also proposes the responsibilities and collaboration for surgeons, anesthesiologists and pain physicians in the management of CPSP, which will have significance in guiding the clinical practice.