POST-SURGICAL NEUROPATHIC PAIN

Surgeons and anaesthetists are involved in Pain Medicine, as they have a responsibility to contribute to postoperative pain management and are often consulted about longer‐term pain problems as well. A large component of persistent pain after surgery can be defined as neuropathic pain (NP). Nerves a...

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Bibliographic Details
Published in:ANZ journal of surgery 2008-07, Vol.78 (7), p.548-555
Main Author: Shipton, Edward
Format: Article
Language:English
Subjects:
Anesthesiology
Humans
Laparoscopy - adverse effects
Laparotomy - adverse effects
Neuralgia - diagnosis
Neuralgia - etiology
Neuralgia - prevention & control
Neurological disorders
neuropathic
pain
Pain management
Pain, Postoperative - diagnosis
Pain, Postoperative - prevention & control
Pharmacology
post-surgery
Postoperative period
Risk Factors
Surgery
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Summary:Surgeons and anaesthetists are involved in Pain Medicine, as they have a responsibility to contribute to postoperative pain management and are often consulted about longer‐term pain problems as well. A large component of persistent pain after surgery can be defined as neuropathic pain (NP). Nerves are injured during surgery and pain can persist after the surgical wound has healed. NP is because of a primary lesion or dysfunction of the peripheral or central nervous system. Prevalence estimates indicate that 2–3% of the population in the developed world experience NP. Persistent post‐surgical NP is a mostly unrecognized clinical problem. The chronicity and persistence of post‐surgical NP is often severely debilitating and impinges on the psychosocial, physical, economic and emotional well‐being of patients. Options for treatment of any neuropathic factors are based on understanding the pain mechanisms involved. The current understandings of the mechanisms involved are presented. There is reasonable evidence for the efficacy of pharmacological management for NP. The aim of this article was to appraise the prevention, diagnostic work‐up, the physical and particularly the pharmacological management of post‐surgical NP and to provide a glimpse of advances in the field. It is a practical approach to post‐surgical NP for all surgeons and anaesthetists. The take‐home message is that prevention is better than waiting for post‐surgical NP to become persistent.
ISSN:1445-1433
1445-2197
DOI:10.1111/j.1445-2197.2008.04569.x