Consequently, it is feasible to suggest the repeatedly observed high prevalence of pain in the early postoperative period may be at least partially the result of a lack of implementation of sufficient pain management strategies. Citation9Īnesthesiologists are at the heart of perioperative analgesic management, both as prescribers and administrators. Citation5 Preventive analgesia can be applied any time perioperatively and usually comprises a multimodal strategy including opioids. Citation3 The goal of present-day perioperative analgesic management, therefore, is to prevent or limit its development through the employment of an aggressive analgesic therapy (preventive analgesia). Citation6 – Citation8 Central sensitization has been suggested the key mechanism underlying PPSP. Citation5 As a result, frequent bursts of afferent activity (nociceptive barrage) enter the central nervous system potentially altering neuronal function and signal transmission (central sensitization). Citation3, Citation4ĭuring surgery, peripheral nociceptors are mechanically stimulated or sensitized by mediators released from tissues and immune cells (peripheral sensitization). Citation1, Citation2 Depending on the surgical procedure, it carries up to 80% risk of becoming persistent (persistent postsurgical pain ). With a prevalence of 30% after surgery, acute pain clearly remains an unresolved problem of modern medicine often impacting on patient outcome.
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