Predictors of persistent pain in women after hysterectomy: A prospective cohort study

Document Type : Original Article


1 Gynecologist, Saveh Chamran Hospital, Saveh, Iran.

2 Anesthesiologist, Mazandaran University of Medical Sciences, Sari, Iran.

3 Assistant Professor, Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

4 Gynecologist, Faculty of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran.

5 Assistant Professor, Department of Obstetrics and Gynecology, Reproductive Health Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.


Introduction: Persistent pain after hysterectomy is unknown in the Iranian population and various factors, including ethnicity, are involved in its occurrence, the effect of which has not been studied in different parts of Iran; therefore, this study was performed with aim to evaluate the prevalence and predictors of persistent pain after hysterectomy.
Methods: This prospective cohort study was performed during April 2019 to March 2020 in the hospitals affiliated to Tabriz University of Medical Sciences. A total of 219 patients who were candidates for hysterectomy completed demographic tools, acute pain visual scale, persistent pain rating scale (NRS) and Beck depression. Finally, the prevalence of persistent pain after surgery was assessed using NRS and its predictors using logistic regression test. P<0.05 was considered statistically significant.
Results: Prevalence of persistent pain after surgery was observed in 35 patients (15.98%).Based on the results of logistic regression, the variable of acute pain in the first hour as 2.11 times (1.85-2.32) and open surgery as 3.24 times (3.88-4.49) increases the risk of persistent postoperative pain.
Conclusion: Hysterectomy laparotomy and acute postoperative pain are independent risk factors for persistent pain after hysterectomy. Identifying high-risk patients before surgery, including patients with pain sensitivity, may provide a unique opportunity to reduce persistent postoperative pain.


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