Chronic pain management after surgery

Chronic post-surgical pain is a common problem affecting between 2% and 10% of adults after surgery and is a significant health burden. The development of chronic post-surgical pain involves multiple mechanisms including peripheral and central sensitization and nerve injury. There are many risk factors including preoperative pain, chemotherapy/radiotherapy, surgical, psychological and genetic factors. The prevention of chronic post-surgical pain is challenging but progress is being made in identifying at-risk groups, improved surgical technique and preventative analgesia including regional analgesia. Accurate diagnosis is essential for prompt management, including identification of neuropathic pain. Management involves identifying any surgically or medically treatable cause, followed by pharmacological, psychological, physical and interventional management. It is essential for all clinicians involved in the care of surgical patients to have an awareness of chronic post-surgical pain, its prevention, diagnosis and treatment.