BMC anesthesiology · 2026
Persistent pocket-site pain after cardiac implantable electronic device implantation: a prospective observational study of prevalence, neuropathic characteristics, and quality of life.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Altun Gozde, Esin Ayla, Ozsahin Yasemin, Arslan Sukru, Balcioglu Sahra Asena, Sandal Baris, Erkalp Kerem, Salihoglu Ziya
Аннотация
BACKGROUND: Although transvenous cardiac implantable electronic device (CIED) implantation is generally considered a minor procedure, long-lasting pocket-site pain may represent an underrecognized clinical problem. This study aimed to evaluate the prevalence, characteristics, and clinical impact of persistent pain after CIED implantation.
METHODS: This prospective observational study included patients who underwent first-time CIED implantation and attended routine outpatient follow-up visits. Pain intensity was assessed using the Visual Analog Scale (VAS), and neuropathic pain characteristics were evaluated using the Douleur Neuropathique 4 Questions (DN-4) questionnaire. Health-related quality of life was assessed using the Short Form-12 (SF-12). Demographic and clinical data were also recorded.
RESULTS: A total of 102 patients were included in the analysis. Persistent implantation-site pain (VAS ≥ 4) was reported by 22.5% of patients. Neuropathic pain characteristics (DN-4 ≥ 4) were identified in 26.5% of patients. A moderate positive correlation was observed between VAS and DN-4 scores (ρ = 0.473, p < 0.001). However, the association between VAS ≥ 4 and DN-4 ≥ 4 was not statistically significant and had a small effect size (p = 0.118; φ = 0.15). Pain intensity was moderately negatively correlated with the SF-12 physical component score, indicating reduced physical quality of life with increasing pain severity, while mental quality of life was not significantly affected.
CONCLUSIONS: Persistent pocket-site pain after CIED implantation affected a clinically meaningful proportion of patients despite generally low overall pain scores. Higher DN-4 scores were associated with poorer physical and mental quality of life and may provide additional clinical information in selected patients. However, because the categorical association between VAS-defined persistent pain and DN-4 positivity was not statistically significant, these findings should be interpreted cautiously and confirmed in larger prospective studies.
METHODS: This prospective observational study included patients who underwent first-time CIED implantation and attended routine outpatient follow-up visits. Pain intensity was assessed using the Visual Analog Scale (VAS), and neuropathic pain characteristics were evaluated using the Douleur Neuropathique 4 Questions (DN-4) questionnaire. Health-related quality of life was assessed using the Short Form-12 (SF-12). Demographic and clinical data were also recorded.
RESULTS: A total of 102 patients were included in the analysis. Persistent implantation-site pain (VAS ≥ 4) was reported by 22.5% of patients. Neuropathic pain characteristics (DN-4 ≥ 4) were identified in 26.5% of patients. A moderate positive correlation was observed between VAS and DN-4 scores (ρ = 0.473, p < 0.001). However, the association between VAS ≥ 4 and DN-4 ≥ 4 was not statistically significant and had a small effect size (p = 0.118; φ = 0.15). Pain intensity was moderately negatively correlated with the SF-12 physical component score, indicating reduced physical quality of life with increasing pain severity, while mental quality of life was not significantly affected.
CONCLUSIONS: Persistent pocket-site pain after CIED implantation affected a clinically meaningful proportion of patients despite generally low overall pain scores. Higher DN-4 scores were associated with poorer physical and mental quality of life and may provide additional clinical information in selected patients. However, because the categorical association between VAS-defined persistent pain and DN-4 positivity was not statistically significant, these findings should be interpreted cautiously and confirmed in larger prospective studies.