Can chronic postsurgical pain be prevented by using regional block?

Abstract

After undergoing a common surgery, 10%-50% of patients complain of acute pain, among whom 2%-10% patients experience transition to severe chronic pain [1]. This persistent postsurgical pain is a clinical problem, as its duration is long. Chronic postsurgical pain (CPSP) is "newly presenting pain after surgery" or "a different type of pain on the operation site" lasting for more than 3 months. Pain with a probable cause, such as cancer or infection, is excluded [2]. There are various risk factors for CPSP with respect to the patient and surgery type. However, the exact cause of CPSP has not been identified. Some studies reported that the surgery type, extent of tissue damage, and neural damage affect CPSP. According to Sasso et al. [3], 43% patients suffered pain for 3 months among the 280 patients who underwent iliac crest bone grafting, and 33% patients complained of pain even for a year. Transversalis fascia plane (TFP) block could be effective in controlling acute postoperative pain after iliac crest bone graft harvesting, as reported by Nicholas et al.

Predictors of Chronic Postsurgical Pain in Elderly Patients Undergoing Hip Arthroplasty: A Multi-Center Retrospective Cohort Study

“…14 CPSP is a chronic pain condition with limited therapeutic strategies compared with those for APOP. [15][16][17] Patients with CPSP endure significant suffering, which might eventually result in depression, anxiety, and other psychological problems. Consequently, this generates a huge economic burden and large consumption of medical resources.…”