MANAGEMENT OF POST-SURGICAL PERIPHERAL NEUROPATHIC PAIN IN ADULTS: A FRENCH SURVEY
Author(s)
Patrice MERTL, MD, PhD1, Alain ASTIER, PharmD, PhD2, Nadine ATTAL, MD, PhD3, Rafik NAMANE, MD4, Raneem ALKATEB, PharmD5, Lamine Mahi, MD6, Anissa BELBACHIR, MD7, Gisèle PICKERING, MD, PhD8.
1Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France, 2French National Academy of Pharmacy, Paris, France, 3Inserm U987, APHP, CHU Ambroise Paré, UVSQ Paris-Saclay, Boulogne-Billancourt, France, 4Laboratoires Grünenthal S.A.S., Puteaux, France, 5Grünenthal GmbH, Stolberg, Germany, 6Axelys Santé, Malakoff, France, 7Department of Anesthesia and Critical Care Medicine, Cochin University Paris-Descartes Hospital, Paris, France, 8CIC INSERM 1405/Plateforme d'Investigation Clinique CHU Gabriel Montpied, Clermont-Ferrand, France.
1Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France, 2French National Academy of Pharmacy, Paris, France, 3Inserm U987, APHP, CHU Ambroise Paré, UVSQ Paris-Saclay, Boulogne-Billancourt, France, 4Laboratoires Grünenthal S.A.S., Puteaux, France, 5Grünenthal GmbH, Stolberg, Germany, 6Axelys Santé, Malakoff, France, 7Department of Anesthesia and Critical Care Medicine, Cochin University Paris-Descartes Hospital, Paris, France, 8CIC INSERM 1405/Plateforme d'Investigation Clinique CHU Gabriel Montpied, Clermont-Ferrand, France.
OBJECTIVES: This survey aims to describe real-world diagnostic and therapeutic practices for post surgical peripheral neuropathic pain (PSNP) in France.
METHODS: A cross-sectional survey was conducted among French physicians involved in post surgical pain management. An online self-administered questionnaire was disseminated in April 2025 either directly or via SFAR and SOFCOT learned societies. The survey explored physician characteristics, patient volume, diagnostic approaches, pain onset timing and treatment strategies.
RESULTS: Overall, 245 of 250 responses were analyzed, 4 were excluded for being out of France and 1 as a duplicate. Most respondents were orthopedic surgeons (89%), followed by general practitioners (7%) and anesthesiologists (4%). Physicians were spread throughout France with 65% practicing in private settings. Moderate self-assessed PSNP knowledge was reported (mean score: 2.87/5). 93% of respondents identified risk factors predicting PSNP onset, which was reported to mostly occur within 3 months post-surgery, although half of them reported an earlier occurrence, less than 1 month (27%) or at 1 month (30%) after surgery. PSNP diagnosis was mainly based on patient-reported symptoms, clinical examination and DN4. First-line PSNP treatments essentially occurred within 3 months after surgery (93%), and included, alone or in association, antiepileptics (28%), non-opioid analgesics (22%), neurostimulation (20%) and topical analgesics (18%). Second-line treatments focused on neurostimulation (20%), alternative medicine (14%), tricyclic antidepressants (25%). Most respondents (58%) evaluated treatment efficacy or considered switching to another line between 1 and 3 months after initiation, primarily based on patient satisfaction and pain intensity scales (VAS, NRS). In case of insufficient pain relief, 96% of respondents reported referral to pain specialists.
CONCLUSIONS: The survey highlights the medical challenges of PSNP and the high referral rate to pain specialists due to treatment failure, emphasizing the need for better-defined, multidisciplinary management strategies. Future guidelines should address timing of intervention, harmonization of diagnosis and treatment sequencing across specialties.
METHODS: A cross-sectional survey was conducted among French physicians involved in post surgical pain management. An online self-administered questionnaire was disseminated in April 2025 either directly or via SFAR and SOFCOT learned societies. The survey explored physician characteristics, patient volume, diagnostic approaches, pain onset timing and treatment strategies.
RESULTS: Overall, 245 of 250 responses were analyzed, 4 were excluded for being out of France and 1 as a duplicate. Most respondents were orthopedic surgeons (89%), followed by general practitioners (7%) and anesthesiologists (4%). Physicians were spread throughout France with 65% practicing in private settings. Moderate self-assessed PSNP knowledge was reported (mean score: 2.87/5). 93% of respondents identified risk factors predicting PSNP onset, which was reported to mostly occur within 3 months post-surgery, although half of them reported an earlier occurrence, less than 1 month (27%) or at 1 month (30%) after surgery. PSNP diagnosis was mainly based on patient-reported symptoms, clinical examination and DN4. First-line PSNP treatments essentially occurred within 3 months after surgery (93%), and included, alone or in association, antiepileptics (28%), non-opioid analgesics (22%), neurostimulation (20%) and topical analgesics (18%). Second-line treatments focused on neurostimulation (20%), alternative medicine (14%), tricyclic antidepressants (25%). Most respondents (58%) evaluated treatment efficacy or considered switching to another line between 1 and 3 months after initiation, primarily based on patient satisfaction and pain intensity scales (VAS, NRS). In case of insufficient pain relief, 96% of respondents reported referral to pain specialists.
CONCLUSIONS: The survey highlights the medical challenges of PSNP and the high referral rate to pain specialists due to treatment failure, emphasizing the need for better-defined, multidisciplinary management strategies. Future guidelines should address timing of intervention, harmonization of diagnosis and treatment sequencing across specialties.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD121
Topic
Epidemiology & Public Health, Health Service Delivery & Process of Care, Real World Data & Information Systems
Disease
Injury & Trauma, Neurological Disorders, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)