Abstract PR288

Abstract

Background & Objectives: Chronic pain has major adverse effects on health-related quality of life and contributes to significant socioeconomic burden [1]. Chronic pain occurs up to 32% after hysterectomy surgery [2]. We aim to investigate the risk factors to reduce chronicity of pain. Materials & Methods: We performed prospective cohort study involving in Asian women who underwent abdominal or laparoscopic hysterectomy for benign conditions. Demographic, psychological and perioperative data were recorded. 4-month, 6-month and 12-month post-operative phone survey were conducted to assess presence of chronic post-hysterectomy pain (CPHP) and functional impairment. Potential univariate risk factors were considered using multivariate logistic regression model to assess for independent risk factors. Results: The incidence of CPHP at 4-month, 6-month and 12-month follow up were 33.9% (55/162), 17.1% (24/140) and 1.7% (2/115) respectively. Women with CPHP 4-month and 6-month had pain that interfered with their sleep and affected activities of daily living. The independent risk factors for CPHP 4-month on multivariate logistic regression were higher mechanical temporal summation score (OR1.07, p=0.0002), higher pain catastrophizing scores (0.0116) especially rumination and helplessness scores preoperatively, higher pain score at recovery room (OR1.51, p=0.0039) and when coughing 24-hours postoperatively (OR1.16, p=0.083). The independent risk factor for CPHP 6-month on multivariate logistic regression were higher mechanical temporal summation score (OR1.13, p=0.0003), higher pain catastrophizing scores (0.0179) especially rumination and helplessness scores preoperatively and higher pain score at recovery room (p=0.015). Conclusion: We concluded that majority of CPHP cases recovered with time but CPHP do have significant impact on activities of daily living. Independent risk factors for CPHP may include higher mechanical temporal summation scores and pain catastrophizing scores preoperatively and increased pain score in immediate postoperative period.