A recent review provides a sobering picture of the missing clinical links in research regarding current pharmacological treatment for chronic postoperative pain.
A review in Anaesthesia provides a sobering picture of the missing clinical links in research regarding current pharmacological treatment for chronic postoperative pain. The review looked at the pathogenic mechanisms thought to contribute to persistent postoperative pain, peri-operative preventative strategies with the potential to reduce the risk of chronic pain, the impact of psychosocial factors and the potential value of genetic analysis to stratify risk and treatment for the individual.
The review is an excellent primer on the criteria for diagnosing chronic postoperative pain, which is characterized by pain of at least 2 months’ duration that developed after a surgical procedure and for which other causes of pain (such as malignancy or chronic infection) have been ruled out.
Among the more interesting findings of the review:
The review also makes important points about the psychology of pain sufferers and pain catastrophizing, as well as providing a brief overview of candidate genes that may play a role in who may develop chronic postoperative pain.
“A better understanding of the natural history and consequences of chronic postoperative pain would facilitate effective strategies for its prevention and treatment,” the reviewers conclude. “Patients should be made aware of the risk of chronic postsurgical pain, particularly where there is a high risk due to the type of surgery or known patient risk factors. This will allow patients to make better informed decisions about whether to proceed with surgery and to understand that surgery may alleviate an existing, intermittent pain but in exchange for a different lifelong pain.”