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pISSN 2005-9159
eISSN 2093-0569

Review Article

Korean J Pain 2023; 36(2): 149-162

Published online April 1, 2023 https://doi.org/10.3344/kjp.23080

Copyright © The Korean Pain Society.

Practical strategies for the prevention and management of chronic postsurgical pain

Bo Rim Kim1 , Soo-Hyuk Yoon2 , Ho-Jin Lee2,3

1Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
2Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea
3Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea

Correspondence to:Ho-Jin Lee
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea
Tel: +82-2-2072-2467, Fax: +82-2-747-8363, E-mail: zenerdiode03@gmail.com

Handling Editor: Francis S. Nahm

Received: March 8, 2023; Revised: March 17, 2023; Accepted: March 18, 2023

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Chronic postsurgical pain (CPSP) is a multifactorial condition that affects a significant proportion of patients undergoing surgery. The prevention and management of CPSP require the identification of preoperative risk factors to screen high-risk patients and establish appropriate perioperative pain management plans to prevent its development. Active postoperative pain management should be provided to prevent CPSP in patients with severe pain following surgery. These tasks have become important for perioperative team members in the management of CPSP. This review article provides a comprehensive overview of the latest research on the role of perioperative team members in preventing and managing CPSP. Additionally, it highlights practical strategies that can be employed in clinical practice, covering the definition and risk factors for CPSP, including preoperative, intraoperative, and postoperative factors, as well as a risk prediction model. The article also explores various treatments for CPSP, as well as preventive measures, including preemptive analgesia, regional anesthesia, pharmacological interventions, psychoeducational support, and surgical technique modification. This article emphasizes the importance of a comprehensive perioperative pain management plan that includes multidisciplinary interventions, using the transitional pain service as an example. By adopting a multidisciplinary and collaborative approach, perioperative team members can improve patient outcomes, enhance patient satisfaction, and reduce healthcare costs. However, further research is necessary to establish targeted interventions to effectively prevent and manage CPSP.

Keywords: Acute pain, Chronic Pain, Neuralgia, Pain Management, Pain, Postoperative, Perioperative Medicine, Postoperative Complications, Surgical Procedures, Operative.