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General and Regional Anesthesia for Patients with Pre-existing Chronic Pain 

General and Regional Anesthesia for Patients with Pre-existing Chronic Pain
General and Regional Anesthesia for Patients with Pre-existing Chronic Pain

Dmitri Souzdalnitski

, Michael P. Smith

, Yili Huang

, and Maged Guirguis

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date: 28 November 2021

Abstract: This chapter examines the specifics of using general and regional anesthesia in patients with chronic pain. Because intraoperative anesthetic management is affected by the presence of chronic pain and relevant chronic pain medications, it is important to identify these patients before surgery and to exercise special precautions during their anesthetic care. A large percentage of patients with chronic pain are on long-term opioid therapy for non-cancer or cancer-associated pain. Tolerance to opioids represents a major challenge in perioperative pain control. Thus special attention to the perioperative care of patients with chronic pain is imperative. When approached with caution and careful perioperative planning for medication, education, monitoring, and maintenance, the anesthesiologist can provide each chronic pain patient with a safe and complete general anesthesia experience. Those patients with multiple comorbidities also benefit greatly from use of regional anesthesia.

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