Chronic postoperative pain has an overall incidence of approximately 30%, with 5% to 10% of cases classified as severe (numerical rating scale \> 6/10). However, its management remains suboptimal, primarily due to underdiagnosis and delayed referral of patients to specialized chronic pain centers.
Improving the screening of patients with chronic postoperative pain is therefore crucial. Our research has shown that early detection of postoperative neuropathic pain is possible using just two text messages (SMS), as early as three months after surgery. Early screening, combined with prompt management, can prevent pain from becoming chronic and mitigate its harmful effects.
Study design
This study is a cluster crossover randomized trial. All participating centers (n=16) will take part in two sequential study periods:
* Control Period: "Without early treatment at 3 months" During this period, patients with persistent postoperative pain-identified via SMS-will receive treatment at 6 months. This reflects the current standard of care for patients with postoperative pain. * Intervention Period: "With early treatment at 3 months" During this period, patients with persistent postoperative pain-identified via SMS-will receive early treatment starting at 3 months.
Study Population
The study will include patients undergoing the following minor surgical procedures:
* Inguinal hernia repair * Breast reduction * Mastectomy with lymph node dissection * Knee arthroscopy * Knee ligament reconstruction
Study Schedule Recruitment Period: 24 months Patient Follow-up: 6 months Total Estimated Study Duration: 30 months
Inguinal hernia repair, regardless of the surgical technique used
Breast reduction
Mastectomy with or without reconstruction but with lymph node dissection
Knee arthroscopy or knee ligamentoplasty
Patients with pain sensitivity defined by the presence of chronic pain, use of level 3 morphine analgesics, use of anxiolytics, gabapentinoids and/or antidepressants
Patients subject to legal protection measures
Patients deprived of their liberty
Pregnant, labouring or breastfeeding patients
Crossover
Early management of postoperative pain at 3 months detected using sms
Other interventionDuring this period, patients with persistent post-operative pain, identified through SMS screening, will receive early treatment starting at 3 months.
Proportion of patients with chronic post-operative pain at 6 months.
Types of chronic post-operative pain at 3 and 6 months: frequency of neuropathic pain and pain due to excessive nociception
Proportion of patients responding to SMS during the various assessments
Sensitivity and specificity of SMS for diagnosing pain with neuropathic characteristics post-operatively at 3 and 6 months
Proportion of patients with pain at 3 and 6 months according to the type of surgery
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