Chronic pain after orthognathic surgery: a retrospective single-center study

Background: We aimed to clarify the occurrence and variables associated with postoperative chronic postsurgical pain in orthognathic surgery patients (OS). Methods: This retrospective single-center study included patients ≥18 years old undergoing bilateral sagittal split osteotomy (BSSO) with or without Le Fort I osteotomy between January 2016 and December 2022. The outcome variable was the occurrence of chronic postsurgical pain three months after OS. SPSS software (IBM Corporation, 28.0.0.0) was used to analyze the associations between predictor variables and outcome. Results: Chronic postsurgical pain was observed in 7.9% of the 317 patients included in this study. In univariate analysis, the outcome was predicted by older age (odds ratio (OR) = 1.044; 95% confidence interval (CI): 1.003–1.087; p = 0.033) and use of early gabapentinoid medication at hospital discharge (OR = 3.526; 95% CI: 1.286–9.666; p = 0.014). In multivariate analysis, only early gabapentinoid medication predicted outcome independently (adjusted odds ratio (aOR) = 2.975; 95% CI: 1.055–8.388; p = 0.039). Conclusions: Chronic postsurgical pain represents a significant postoperative disadvantage in OS, yet surgical factors appear to have limited influence on its development. More detailed information on other variables, such as psychosocial factors and resilience, is needed to predict postoperative pain in this specific patient group.

Orthognathic surgery; Chronic postsurgical pain; Trigeminal nerve injury; Psychiatric aspects; Postoperative period; Retrospective studies

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