PhD Conferral Mrs. Daisy M.N. Hoofwijk, MSc.

Keywords: chronic pain, chronic postsurgical pain, postoperative pain

"The way to understanding Chronic Postsurgical Pain; From clinical and psychological predictors to incorporating genetics"

Chronic postsurgical pain (CPSP) is a common problem, which may lead to a decreased quality of life, absence from work and increased healthcare costs. The aim of this dissertation was to provide insight into the interaction between clinical, psychological and genetic risk factors for developing CPSP. The prevalence of CPSP one year postsurgery was 15.3%. This rate was greatly affected by the type of intervention. Orthopaedic interventions were associated with the highest prevalence of CPSP. Risk factors for the development of CPSP included the presence of preoperative pain, preoperative use of pain medication, fear of surgery, pessimism and a low preoperative quality of life. A genetic risk factor for the development of CPSP three months after hysterectomy was a polymorphism (i.e. a genetic variant) in the COMT gene.