Chronic postsurgical pain

Abstract

Chronic postsurgical pain (CPSP) is the consequence of acute postoperative pain. Unfortunately, despite many attempts of improvement, the treatment of acute postoperative pain remains unsatisfactory. In the present review, the probable reasons for this will be reviewed. Based on the demonstration of specific, patients-related 'pain risk', individual pain trajectories and the importance of secondary hyperalgesia in the development of CPSP, new methods have to be applied in order to determine the real efficacy of new analgesic adjuvants. The key importance of the early inflammatory reaction in the genesis of the 'postoperative syndrome' and its close interaction with the mechanisms elicited by intraoperative opioid administration must also be outlined. A single treatment approach is almost unlikely to solve the problem of CPSP. Consequently, the management of postoperative pain has to become more patients' specific and etiologies sensitive.