Persistent postsurgical pain

<p>Lynn Cintron</p>

Persistent postsurgical pain

Lynn Cintron

University of California, USA

: Analg Resusc: Curr Res

Abstract

Chronic pain after surgery is a significant problem that reduces the quality of life of patients. More than 45 million surgical procedures are performed in the United States each year. It has been estimated that acute postoperative pain will develop into persistent postoperative pain (PPP) in 10% to 50% of individuals after common operations. Since chronic pain can be severe in up to 10% of these patients, PPP represents a major clinical problem—affecting at least 450,000 people each year. Despite improved understanding of the process, interpretation of pain signals, and the development of new analgesic techniques, under-treatment of postoperative pain continues to be a problem. Iatrogenic neuropathic pain is a common cause of PPP. Treatment should be targeted at the progression of mechanisms leading to neuro-degeneration. Furthermore, we need to educate patients wanting surgery for reasons other than illness or disability of the risk of the development of PPP. It is recognized that aggressive peri-operative interventions can reduce the intensity of acute postoperative pain, which reduces the risk of a patient developing PPP. Risk factors include genetics, psychosocial issues, pain disorders, age/gender, acute pain and type of surgery. Based on all these factors, it is appropriate to apply a multimodal approach to preventing postoperative pain. This presentation will review strategies for the identification of patients at risk for PPP, as well as possible treatment strategies.