Acute and chronic post-surgical pain after live liver donation: Incidence and pr

[Clark]

http://www.ncbi.nlm.nih.gov/pubmed/25045167

Liver Transpl. 2014 Jul 5. doi: 10.1002/lt.23949. [Epub ahead of print]
Acute and chronic post-surgical pain after live liver donation: Incidence and predictors.
Holtzman S1, Clarke HA, McCluskey SA, Turcotte K, Grant D, Katz J.

Abstract
Despite its prominence as a concern among potential surgical candidates, there is little information in the literature regarding the short- and long-term pain experience after live liver donation. We undertook a prospective study to examine: (1) the nature and incidence of acute and chronic pain after live donor hepatectomy, and (2) the factors associated an increased or decreased risk of adverse pain outcomes. Prior to donation, a comprehensive assessment of potential predictors of acute and chronic pain outcomes was conducted, including donors' pain expectations, psychosocial factors, medical history, and demographic factors. Detailed data regarding pain outcomes was collected post-operatively (day one and day two), and again at a six- and twelve-month follow-up telephone interview. A total of 65 adults (33 female, 32 male) scheduled for a donor hepatectomy participated. A substantial proportion of donors reported a moderate-to-severe level of pain intensity (> 4 on a 0-10 scale) at rest and at movement on day one (42%, 74%) and day two (33%, 32%). Persistent post-surgical pain was reported by 31% of donors at the six-month follow-up and by 27% of donors at the twelve-month follow-up. Generally, this pain was mild and pain-related life interference was minimal. Female gender, younger age, and several pre-donation measures of pain-related anxiety were associated with a significantly greater risk of developing persistent post-surgical pain. This study identifies a subset of patients who experience persistent pain after live liver donation. Additional prospective research using larger samples of liver donors is needed to replicate this work, to obtain a more detailed account of the acute and long-term pain experience, and to determine if targeted interventions can minimize the frequency and severity of chronic pain.