Chronic postsurgical pain: still a neglected topic?

Figures & data

Figure 1 Flow chart of screened, excluded, and included articles on chronic postsurgical pain (1981–2010).

Table 1 Numerical representation of topic-in-title articles on chronic pain after specific surgeries, 1981–2010a

No	Terms of surgical interventionsb	Number of topic-in-title articles
1	Herniorrhaphy OR “hernia repair”	54
2	Amputationc	47
3	“Thoracic surgery” OR thoracotomy	28
4	Arthroplasty OR “knee replacement” OR “hip replacement”	21
5	“Breast surgery” OR “breast reconstruction” OR mastectomy	15
6	“Cardiac surgery” OR “CABG surgery” OR sternotomy	13
7	“Gallbladder surgery” OR cholecystectomy	5
8	Prostatectomy	3
Total		186

Notes:

a Electronic (via PubMed) and manual search of the literature on chronic postsurgical pain.

b AND the following pain-related terms: “chronic pain” OR “neuropathy” OR “neuralgia” were added.

c the following terms: “phantom pain” OR “residual limb pain” were added to the pain-related terms.

Abbreviation: CABG, coronary artery bypass grafting.

Table 2 Editorials on chronic postsurgical pain

Years	Number of editorials		References
	All journals	Surgical journals
81–85	0	0
86–90	0	0
91–95	0	0
96–00	0	0
01–05	2	0	^Citation22,Citation23
06–10	7	0	^Citation24^–^Citation30

Table 3 Topic-in-title articles on chronic postsurgical pain, 1981–2010

Years	Numbers of articlesa
	All journalsb	Surgical journals
81–85	0	0
86–90	0	0
91–95	2	2
96–00	9	2
01–05	15	6
06–10	31	10

Notes:

a Articles with titles clearly indicating that they are devoted to postsurgical chronic pain. Searched as articles on chronic pain after surgery in general: “chronic pain” OR “neuropathic” AND “surgery” OR “postoperative;”

b including surgical journals.

Table 4 Comparisons of topic-in-title articles on chronic and acute postsurgical pain

Years	“Chronic pain”a AND “surgery”b IN TITLE		“Pain” NOT “chronic” AND “surgery”b IN TITLE
	Number of articles	As a percentage of “chronic pain”a onlyc	Number of articles	As a percentage of “pain” onlyc
81–90	0	0%	626	6.8%
91–00	11	0.6%	1137	6.5%
01–10	46	0.8%	2117	5.8%

Notes:

a OR “neuropathic;”

b OR “postoperative;”

c without “surgery” or “postoperative.”

Table 5 Time-related progress in numerical representation of topic-in-title articles on chronic pain after specific surgeries

No	Specific surgeries	All journals			Surgical journalsa
		81–90	91–00	01–10	81–90	91–00	01–10
1	Herniorrhaphy	0	5	49	0	5	41
2	Limb amputation	7	18	22	0	4	2
3	Thoracic surgery	2	10	16	0	4	6
4	Arthroplasty	6	4	11	2	2	6
5	Breast surgery	1	5	9	0	0	0
6	Cardiac surgery	1	4	8	0	1	0
7	Gallbladder surgery	0	4	1	0	1	0
8	Prostatectomy	0	0	3	0	0	1

Note:

a Number of articles in all surgical journals covered by PubMed.

Table 6 Top Journal Selectivity Index (TJSI) for representation of chronic pain as an adverse effect of surgery

Topic of publications	Years	Number of articlesa		TJSI (ratio of top to all)
		All journalsb (>5000)	Top specialty journalsc (20)
Chronic postsurgical pain: herniorrhaphy	91–00	5	2
	01–10	49	18	36.7%
Chronic postsurgical pain: seven specific surgeriesd	91–00	45	1
	01–10	70	2	2.9%

Notes: TJSI represents the number of articles published in the top 20 journals to the number of articles in all journals covered by PubMed;^11,12

a Topic-in-title articles;

b journals covered by PubMed;

c top 20 surgical journals sorted by impact factor (journal citation report, 2010);

d limb amputation, thoracic surgery, arthroplasty, breast surgery, cardiac surgery, gallbladder surgery, prostatectomy.

Table 7 Presentation of chronic postsurgical pain in surgical textbooks

	Sabiston Textbook of Surgery, 2008	Schwartz’s Principles of Surgery, 2009	Greenfield’s Surgery, 2010	Miller’s Anesthesia, 2010
Total number of pages	2286	1776	2074	3084
Total number of linesa on the topic	85	70	64	100
Total number of references on the topic	4	2	5	12
Presence of the topic in chapters
Basic principles	+	+	−	+
Limb amputation	−	−	+	−
Thoracotomy	−	−	−	+
Coronary artery bypass grafting	−	−	−	+
Mastectomy	−	−	+	−
Inguinal herniorrhaphy	+	+	+	−

Note:

a Approximately 120 lines per page.

Figure 2 Number of topic-in-title articles published in 1991–2000 and 2001–2010 periods on chronic pain after the four types of specific surgeries.^a Notes: ^aAlong the vertical axis, the number (#) of articles published in all journals (including surgical journals), the number of articles published in surgical journals (including top 20 surgical journals), and the number of articles published in top 20 surgical journals (listed in the method section). Along the horizontal axis, the four types of specific surgeries with the highest number of published articles.

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