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- Title
Przetrwały ból pooperacyjny.
- Authors
Zajączkowska, Renata; Wordliczek, Jerzy
- Abstract
Persistent postoperative pain is defined as a chronic pathological pain, which arises as a result of a surgical procedure and persists beyond normal tissue healing time, whose intensity and location cannot be explained by the presence of other causes, such as relapse, infection, or recurrence in the case of cancer. It usually develops after limb amputations and surgical procedures involving the trunk (thoracotomy, breast surgery, reduction of pelvic fractures, prostatectomy, and cardiac surgery). It is affected by a number of pre-, intra- and post-surgical factors, which are discussed in detail in this paper. The most effective persistent postoperative pain management strategy is to prevent it. The key measures aimed at reducing the risk of persistent postoperative pain include: the recognition of predisposing factors, proper identification of high-risk patients and taking individual therapeutic measures accordingly, including surgery eligibility criteria that include a careful risk/benefit assessment, appropriate surgical techniques (minimally invasive techniques, nerve identification and protection) minimising the risk of intraoperative nerve damage and proper anaesthesiology care of the patient during the intra- and postoperative period as well as effective postoperative pain relief. Where possible, the underlying condition should be addressed (e.g. decompression or repair of an injured nerve). In other patients, symptomatic treatment is preferred. Since in most cases persistent postoperative pain is neuropathic in nature, it should be treated using appropriate neuropathic pain treatment algorithms combined with psychotherapy and rehabilitation.
- Subjects
OPERATIVE surgery; PAIN management; POSTOPERATIVE pain; BREAST surgery; CHRONIC pain; PELVIC fractures; CANCER pain; ANALGESIA; POSTOPERATIVE care
- Publication
Anaesthesiology & Rescue Medicine / Anestezjologia i Ratownictwo, 2020, Vol 14, Issue 4, p356
- ISSN
1898-0732
- Publication type
Article