Identification du risque de douleur chronique après hépatectomie pour don de foie par les trajectoires de douleur

Abstract

ObjectivesTo assess pain trajectories in predicting risk of chronic postoperative pain (CPP) after liver resection for living donor transplantation. Study designRetrospective analysis of patients undergoing liver resection for living donor transplantation during 3years. Patients and methodsAfter recording perioperative data, patients presenting CPP at 3months were separated from patients without postsurgical pain problem in order to build a pain trajectory for liver donor patients without CPP. Postoperative course of liver donors with CPP was then compared to that standard pain trajectory. ResultsSixty-five patients (30 females, 35 males) were included. Epidural analgesia was used in 66%; others received autocontrolled analgesia by morphine. Severe acute pain was expressed by 11% and 37% at rest and movement respectively on the first day. Chronic pain involved six patients without any link with gender or type of analgesia. Analysis of pain trajectories shown that these patients presented either higher initial pain at day 1 or positive slopes with worsening of pain. ConclusionAcute postoperative pain is a risk factor of developing CPP. Identification of those people by pain trajectories can be useful to treat them early.