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B317 Persistent post-surgical pain after total abdominal hysterectomy at a tertiary care hospital of a low-middle income country
  1. A Ahmed,
  2. G Afshan and
  3. R Khan
  1. Aga Khan University, Karachi, Pakistan


Background and Aims Persistent post-surgical pain (PPSP) is pain that lasts for 3 months or more after a surgical procedure, excluding other causes of pain. There has been considerable work in high income countries on incidence and factors related to PPSP. However, there is scarce knowledge about PPSP in low- and middle-income countries (LMICs). We assessed the prevalence of PPSP after total abdominal hysterectomy (TAH), its intensity and effect on daily routine.

Methods It was a prospective cross-sectional study. Approval was obtained from the institution’s Ethics Review Committee. Patients undergoing elective TAH were recruited. A pain nurse called the patients three months after surgery and asked about presence of pain, its location, type, degree and associated factors. Patients who reported pain at three months were called again a year later.

Results During the study period 119 patients underwent TAH. At discharge, 74 (61.3%) were satisfied with their pain management. Three months later, 15 (12.6%) patients reported pain. Pain was mild in 13 and moderate in two patients. At one-year follow-up, two patients (1.6%) reported pain that was mild to moderate in intensity. Pain disturbed sleep in both patients and disturbed daily life routines in one patient.

Conclusions There is scarce knowledge about prevalence of PPSP in LMICs. In our patient population, 12.6% reported pain three months after TAH, while at one year, 1.6% patients reported mild to moderate pain. Multicenter studies are recommended for determining the overall prevalence in our patient population and for getting directions for making targeted efforts towards its prevention and treatment.

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