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Cited by 44Anesthesia and Pain ManagementPain Mechanisms and TreatmentsPain Management and Treatment

Causes and prevention of chronic postsurgical pain

Van de Ven, Thomas J., John Hsia, Hung-Lun·2012·Current Opinion in Critical Care
DOI 10.1097/mcc.0b013e3283557a7f
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Abstract

PURPOSE OF REVIEW: Surgical incision invariably causes some measure of nerve damage and inflammatory response that, in most cases, heals quickly without long-term negative consequence. However, a subset of these patients go on to develop lasting neuropathic pain that is difficult to treat and, in many cases, prevents the return to normal activities of life. It remains unknown why two patients with identical surgical interventions may go on to develop completely divergent pain phenotypes or no pain at all. Aggressive, early analgesic therapy has been shown to reduce the incidence of chronic postsurgical pain (CPSP), but no specific regional anesthetic technique or systemic pharmacologic therapy has been shown to prevent CPSP. RECENT FINDINGS: Inflammation and glial cell activation have recently been shown to be just as important in the transition from normal acute pain to pathologic chronic pain as nerve injury itself and that central sensitization may not be solely due to repetitive nociceptive firing at the time of nerve injury. This has opened a number of new therapeutic possibilities for prevention of CPSP. SUMMARY: Here, we discuss the causes of CPSP and current useful preventive strategies in the perioperative period. We also discuss future potential disease-modifying treatments of CPSP.

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Crossref · 10.1097/mcc.0b013e3283557a7f

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  • Another study found no difference in chronic phantom pain incidence between epidural analgesia throughout the perioperative period and patient-controlled opioid analgesia throughout the perioperative period.

    “In contrast, another study did not find a difference in the incidence of chronic phantom pain with an epidural analgesia throughout the perioperative period, compared with the use of a patient-controlled opioid analgesia throughout the perioperative period [27].”

    From Chronic postsurgical pain: current evidence for prevention and management (2018) · cites this paper as [27]

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Authors
Van de Ven, T. J., & John Hsia, H.-L.
Venue
Current Opinion in Critical Care
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2012-08
Volume
18
Issue
4
Pages
366-371
ISSN
1070-5295 (ISSN-L)
DOI
10.1097/mcc.0b013e3283557a7f
OpenAlex
W2313199679
Cited by
44
References
47
Citations by year
2026: 1 · 2025: 1 · 2024: 4 · 2023: 5 · 2022: 3 · 2021: 2 · 2019: 2 · 2018: 5 · 2017: 3 · 2016: 2 · 2015: 8 · 2014: 4 · 2013: 3
FWCI
0.93
Type
journal article
Language
en
Open access
closed
Locations
  • Current Opinion in Critical Care (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • National Institute of General Medical Sciences (T32GM008600)
Topics
  • Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords
chronic postoperative pain, neuropathic pain, surgical nerve injury, postoperative inflammation, glial activation, central sensitization, analgesic treatment, regional anesthesia, disease-modifying therapy
MeSH terms
Anesthesia, Conduction, Chronic Disease, Humans, Inflammation, Neuralgia, Neuroglia, Pain, Postoperative, Postoperative Pain, Risk Factors

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