RESUMEN
OBJECTIVES: Post cholecystectomy pain syndrome can cause significant distress, impairs quality of life and exacerbations often result in emergency visits. Poorly controlled postoperative pain is a recognized cause of persistent postsurgical pain. Abdominal myofascial pain syndrome is an underdiagnosed cause of persistent pain in this cohort. The objective was to estimate the incidence of poorly controlled postoperative pain in the first 48â¯h after surgery and the likelihood of developing persistent pain at 12â¯months. METHODS: The patients undergoing laparoscopic cholecystectomy at a tertiary unit were consented for participation in a prospective service evaluation. A telephone review was performed at three, six and twelve months after surgery. Incidence of poorly controlled pain in the first 48â¯h after surgery was assessed. Patients with persistent pain were referred to the pain clinic. RESULTS: Over a six-month period, 200 patients were assessed. Eleven patients were excluded (5.5â¯%). Twelve patients were lost to follow-up (6.6â¯%, 12/189). Patient satisfaction with acute postoperative pain management was low in 40â¯% (76/189). Poorly controlled postoperative pain was reported by 36â¯% (68/189) of patients. Incidence of persistent pain was 29â¯% (54/189) at 12â¯months post-surgery. Over half of patients with persistent pain (63â¯%, 34/54) reported poorly controlled postoperative pain. A somatic source was diagnosed in 54â¯% (29/54) with post cholecystectomy pain syndrome. CONCLUSIONS: Poorly controlled postoperative pain was reported by a third of patients. Persistent pain was present in 29â¯% at twelve months post-surgery. Abdominal myofascial pain syndrome should be considered as a differential diagnosis in post cholecystectomy pain syndrome.