Dolor posquirúrgico crónico
Definition
Chronic postsurgical pain is chronic pain developing or increasing in intensity after a surgical procedure and persisting beyond the healing process, i.e. at least 3 months after surgery. The pain is either localized to the surgical field, projected to the innervation territory of a nerve situated in this area, or referred to a dermatome (after surgery/injury to deep somatic or visceral tissues). Other causes of pain including infection, malignancy etc. need to be excluded as well as pain continuing from a pre-existing pain problem. The postsurgical etiology of the pain should be highly probable; if it is vague, consider using codes in the section of chronic primary pain. Dependent on type of surgery, chronic postsurgical pain often may be neuropathic pain. Even if neuropathic mechanisms are crucial, this type of pain should be diagnosed here. The postsurgical etiology of the pain should be highly probable; if it is vague, consider using codes in the section of chronic primary pain. The most frequent surgical procedures causing chronic post-surgical pain are breast surgery (including mastectomy with or without axillary node dissection, cosmetic surgery), herniotomy (open or laparoscopic surgery), thoracic surgery (including minimally invasive procedures like thoracoscopic surgery) and the amputation of a limb or other organ. Dependent on the type of surgery, chronic postsurgical pain often may be neuropathic pain; on average chronic postsurgical pain is in 30% of cases of neuropathic origin (range 6 to 54% and more). Diagnostic Criteria: Conditions A to E are fulfilled: A. Chronic pain (persistent or recurrent for longer than 3 months) is present. B. The pain began or increased in intensity after surgery. C. The pain is in an area of preceding surgery. D. The pain persisted for at least 3 months after the initiating event. E. The pain is not better accounted for by an infection, a malignancy, a pre-existing pain condition or any other alternative cause. [No translation available]
Coding note
La etiología posquirúrgica del dolor debe ser altamente probable; si es vago, considere usar códigos en la sección de dolor primario crónico.
Inclusions
- Dolor crónico después de amputación
- Dolor crónico después de artroplastia
- Dolor crónico después de cirugía de mama
- Dolor crónico después de cirugía espinal
- Dolor crónico después de hernioplastía
- Dolor crónico después de histerectomía
- Dolor crónico después de toracotomía