In the vast majority of cases, a surgical procedure helps to eliminate or reduce pain in the targeted area. However, in rare cases, complications or unforeseen circumstances can result in the onset of what’s known as chronic postsurgical pain.
Today, we’re going to take a closer look at CPSP, and how it is prevented and treated.
Treating Chronic Pain After Surgery
Medical experts define chronic postsurgical pain as pain that persists for at least two months after surgery and is not attributable to a preexisting condition. Oftentimes CPSP is considered neuropathic in nature, and patients describe the pain as shooting, burning, tingling or electrical in nature. Some procedures that have a higher rate of CPSP after surgery include:
- Coronary artery bypass surgery
- Spine surgery
- Breast surgery
- Hip surgery
- Inguinal hernia repair
- Cesarean section
Doctors believe that CPSP develops because stress from the operation, inflammation or nerve damage results in neuronal hypersensitivity that results in the expression of chronic pain flare ups long after the surgical site has healed.
Risks and Prevention
There are a number of factors that increase a person’s risk of developing chronic postsurgical pain after an operation. Those factors include undergoing repeat surgeries, lengthy surgeries, open procedures instead of minimally invasive surgeries, and undergoing an operation in a previously injured area. On the doctor’s end, a surgeon can increase a person’s risk of developing CPSP if there is intraoperative nerve damage, which is more likely to occur in difficult operations, surgeries involving severe trauma, or surgeries near the spinal cord and central nervous system.
The main way surgical teams prevent CPSP is through surgical techniques and improved operative practices. If possible, the surgeon will opt for a laparoscopic procedure in lieu of an open procedure, because minimally invasive options have a decreased likelihood of CPSP. Another thing surgical teams will do is carefully administer analgesic agents with different mechanisms of actions during the pre-, intra- and post-operative periods. These approaches reduce peripheral and central sensitization and are associated with enhanced efficacy and fewer adverse reactions.
Should you develop CPSP after an operation, reach out to a chronic pain doctor in your area to see what solutions are available to you.
Thomas Cohn, MD
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