Practical strategies for the prevention and management of chronic postsurgical pain

Abstract

Chronic postsurgical pain (CPSP) is a multifactorial condition that affects a significant proportion of patients undergoing surgery. The prevention and management of CPSP require the identification of preoperative risk factors to screen high-risk patients and establish appropriate perioperative pain management plans to prevent its development. Active postoperative pain management should be provided to prevent CPSP in patients with severe pain following surgery. These tasks have become important for perioperative team members in the management of CPSP. This review article provides a comprehensive overview of the latest research on the role of perioperative team members in preventing and managing CPSP. Additionally, it highlights practical strategies that can be employed in clinical practice, covering the definition and risk factors for CPSP, including preoperative, intraoperative, and postoperative factors, as well as a risk prediction model. The article also explores various treatments for CPSP, as well as preventive measures, including preemptive analgesia, regional anesthesia, pharmacological interventions, psychoeducational support, and surgical technique modification. This article emphasizes the importance of a comprehensive perioperative pain management plan that includes multidisciplinary interventions, using the transitional pain service as an example. By adopting a multidisciplinary and collaborative approach, perioperative team members can improve patient outcomes, enhance patient satisfaction, and reduce healthcare costs. However, further research is necessary to establish targeted interventions to effectively prevent and manage CPSP.

Keywords: Acute pain; Chronic Pain; Neuralgia; Operative; Pain; Pain Management; Perioperative Medicine; Postoperative; Postoperative Complications; Surgical Procedures.

Fig. 1

Schematic diagram of interventions for the management of chronic postsurgical pain (CPSP) by perioperative time flow. Routine management for all surgical patients is presented in blue colored rectangles, conditions requiring additional interventions are presented in yellow colored pentagons, and further treatment options are presented in green colored rectangles.