[Chronic pain after surgery: State of the art]

Abstract

Any type of surgery can lead to persistent pain (Chronic Post-Surgical Pain, CPSP), including minor or less invasive procedures. CPSP often but not always includes neuropathic pain features; when a neuropathic component is present, CPSP is more severe. The major risk factors for the development of CPSP are well known but not selective. New tools to target high-risk patients preoperatively are currently being assessed (e.g. the risk index from Althaus and colleagues) but remains not specific enough. Today, the prevention of CPSP might be improved by a better management of the patients, specifically by a better control of severe acute postoperative pain (i.e. early diagnosis of a neuropathic component involved, judicious utilization of peri-operative opioid analgesics, use of pain trajectories to better assess postoperative pain resolution).