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Prevention of Chronic Postoperative Pain after Hospitalization: Myth or Reality? 

Prevention of Chronic Postoperative Pain after Hospitalization: Myth or Reality?
Chapter:
Prevention of Chronic Postoperative Pain after Hospitalization: Myth or Reality?
Author(s):

Harsha Shanthanna

, Hari Kalagara

, and Loran Mounir Soliman

DOI:
10.1093/med/9780199349302.003.0027
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date: 22 August 2019

Abstract: This chapter describes the epidemiology, management, and prevention of chronic postsurgical pain. Up to one half of patients suffer from chronic postsurgical pain. Pre-existing chronic pain near the surgical site and pain elsewhere in the body are key predictors of chronic postsurgical pain. Present knowledge of the nature and causation of chronic postsurgical pain is inadequate for developing effective prediction and hence prevention of chronic postoperative pain. It is suggested that a multifaceted but individually tailored approach be used, including identification of risk factors and aggressive treatment of acute postsurgical pain, with continuing treatment of the pre-existing pain. Good evidence exists for thoracic epidural for thoracotomies, paravertebral block for cancer breast surgeries, and the use of ketamine. The use of pregabalin and gabapentin has a good rationale, but there is mixed evidence for their use.

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