The Acute to Chronic Pain Transition: Can Chronic Pain Be Prevented?

Abstract

Chronic postsurgical pain (CPSP) is a distressing disease process that can lead to long-term disability, reduced quality of life, and increased health care spending. Although the exact mechanism of development of CPSP is unknown, nerve injury and inflammation may lead to peripheral and central sensitization. Given the complexity of the disease process, no novel treatment has been identified. The preoperative use of multimodal analgesia has been shown to decrease acute postoperative pain, but it has no proven efficacy in preventing development of CPSP.

Keywords: Central sensitization; Chronic postsurgical pain; Gabapentinoids; Ketamine; Neuropathic pain; Peripheral sensitization; Quantitative sensory testing.