Chronic pain after surgery: What can we do to prevent it?

Abstract

The development of chronic pain after surgery is not an uncommon event. Despite increased attention devoted to this topic in the recent medical literature, little is known about the underlying mechanisms, natural history, and response to therapy of each syndrome. Central nervous system plasticity that occurs in response to tissue injury may contribute to the development of persistent postsurgical pain. As evidence continues to accumulate concerning the role of central sensitization in the prolongation of postoperative pain, many researchers have focused on methods to prevent central neuroplastic changes from occurring through the use of preemptive or preventative analgesic techniques. Effective preventative analgesic techniques may be useful in reducing not only acute pain but also chronic postsurgical pain and disability. This review examines the efficacy of using a variety of analgesic techniques aimed at preventing or reducing chronic pain after surgery. Specific chronic postsurgical pain syndromes evaluated include complex regional pain syndrome, phantom limb pain, chronic donor site pain, post-thoracotomy pain syndrome, and postmastectomy pain syndrome.

Management of neuropathic pain after surgical and non-surgical trauma with lidocaine 5% patches: study of 40 consecutive cases

“…The development of chronic pain after surgery and trauma is not an uncommon event 3 . The frequency, prevalence and natural history of these painful neuropathies are however not exactly known 2 .…”

Was lernen wir aus dem Fall Scott Reuben?

“…Kaye et al [11] [28,30,33,35,54] und an einer weiteren mitgewirkt [27]. Von diesen Arbeiten wurde eine vonseiten der Zeitschrift Journal of Bone and Joint Surgery zurück-gezogen [35].…”

Douleurs séquellaires postopératoires (chirurgie du rachis, chirurgie prothétique)

“…Le type de chirurgie est aussi un élément important, notamment les chirurgies ou voies d'abord susceptibles d'entraîner des lésions nerveuses.La prévention repose sur une approche multimodale[1,34] :…”