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Acta clinica Croatica, Vol. 62. No. Supplement 4, 2023.

Review article

https://doi.org/10.20471/acc.2023.62.s4.13

Chronic Postoperative Pain

Nebojša Ladjević orcid id orcid.org/0000-0001-9569-4954 ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Center for Anesthesiology and Reanimatology, University Clinical Centre of Serbia, Belgrade, Serbia
Maja Milinić ; Center for Anesthesiology and Reanimatology, University Clinical Centre of Serbia, Belgrade, Serbia
Vesna Jovanović orcid id orcid.org/0000-0001-8259-2887 ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Center for Anesthesiology and Reanimatology, University Clinical Centre of Serbia, Belgrade, Serbia
Jelena Jovičić ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Center for Anesthesiology and Reanimatology, University Clinical Centre of Serbia, Belgrade, Serbia
Ivana Likić ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Gyneacology and Obstetrics, University Clinical Centre of Serbia, Belgrade, Serbia
Nikola Ladjević ; Clinic for Urology, University Clinical Centre of Serbia, Belgrade, Serbia

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Abstract

Chronic postoperative pain (CPOP) is a serious health issue that affects millions
of patients every year. The incidence of CPOP is the highest after amputations, inguinal hernioplasty,
thoracotomies, cardiac surgery and breast surgery. In addition to surgical factors, the other risk factors are:
female gender, younger age, preoperative pain, psychological state and acute postoperative pain. The most
common expression of CPOP is neuropathic pain after surgical trauma. The treatment of chronic postoperative
neuropathic pain (CPNP) is difficult. Various methods have been recommended for its prevention,
the most important being techniques that avoid nerve damage and adequate perioperative analgesia. The
goal of this review was to discuss data from published studies examining the incidence, risk factors and
mechanisms of CPOP, with a focus on surgery, the unique opportunity to implement pharmacological
strategies for prevention of CPNP and current pharmacotherapy approaches for treatment of CPNP.
Commonly used drugs to prevent and treat CPNP in the current clinical setting are: opioids, α2-adrenergic
agonists, cyclooxygenase antagonists, gabapentin, pregabalin, steroids, N-methyl-D-aspartate receptor
antagonists and local anesthetics.

Keywords

chronic postoperative pain; neuropathic pain; sensitization; microglia; pharmacotherapy; analgesia

Hrčak ID:

316570

URI

https://hrcak.srce.hr/316570

Publication date:

1.11.2023.

Article data in other languages: croatian

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