Persistent postsurgical pain: risk factors and prevention. Generally, there are signs of nerve injury, especially after herniorrhaphy, mastectomy, thoracotomy, and mandibular osteotomies. Thereby defining neuropathic pain is essential to develop strategies for persistent chronic pain prevention and treatment.
There may also be effective nerve damage, a neuropathic component may develop immediately after surgery and persist in the absence of peripheral nociceptive or inflammatory stimulus. There is pain evoked by touching the wound, motion, breathing, coughing, or gastrointestinal activity. In the immediate postoperative period, direct activation of nociceptors, inflammation, and possible damage to nerve structures cause pain at rest or incident pain at the surgical site and nearby region. Persistent postoperative chronic pain (POCP) is defined as pain lasting for two or more months after surgery, when other causes of pain are excluded, such as cancer or chronic infection. Consequences of inadequate postoperative pain relief and chronic persistent postoperative pain. It is known that such factors involved in this process of chronicity may be biological, psychological, and social.
POCP has been described for a number of diseases of varied duration, mainly characterized by a lack of understanding of the factors that initiated or maintained its development. Usually, the therapeutic options for the overall improvement of POCP are not yet defined, which facilitates the occurrence of disability and direct interference in the quality of life of affected patients. However, there are few consistent data in the literature, so this article aims to draw a picture of the current literature available. Postoperative chronic pain (POCP) has been the focus of several investigations in recent years, contributing to solve uncertain questions on the subject, such as the possible evolutionary mechanisms of acute pain to POCP. Apesar dos esforços para entender e selecionar os pacientes de risco, o manuseio e a prevenção dessa síndrome continuam desafiantes e inapropriados.ĭor crônica pós-operatória Analgesia Prevenção Tratamento Fatores de risco Técnicas que evitem a lesão de nervos estão recomendadas e devem ser usadas sempre que possível. A dor neuropática decorrente do trauma cirúrgico ainda é a expressão mais comum dessa entidade. Conclusão:Ī dor crônica persistente pós-operatória é uma entidade complexa e de etiologia ainda não esclarecida, que interfere intensamente na vida do sujeito. Os principais medicamentos e técnicas são expostos de forma compreensiva. Conteúdo:Įsta revisão descreve a definição, os fatores de risco e os mecanismos da DCPO, sua prevenção e seus tratamentos. Este artigo se propõe a trazer o que há no panorama da literatura atual disponível. Apesar de mais estudos e pesquisas terem sido desenvolvidos a respeito dos possíveis mecanismos da evolução da dor aguda para dor crônica pós-operatória, ainda não existem dados consistentes a respeito de seus fatores de risco e prevenção. Postoperative chronic pain Analgesia Prevention Treatment Risk factorsĪ dor crônica persistente pós-operatória (DCPO) constitui um grave problema de saúde, incapacitante, mina a qualidade de vida dos pacientes acometidos. Despite efforts to understand and select risk patients, the management and prevention of this syndrome remain challenging and inappropriate. Techniques to prevent nerve injury are recommended and should be used whenever possible. Neuropathic pain resulting from surgical trauma is still the most common expression of this entity. Postoperative persistent chronic pain is a complex and still unclear etiology entity, which interferes heavily in the life of the subject. The main drugs and techniques are exposed comprehensively. This review describes the definition, risk factors, and mechanisms of POCD, its prevention and treatment. This article aims to bring what is in the panorama of the current literature available. Although more studies and research have addressed the possible mechanisms of the evolution from acute pain to chronic postoperatively, there are still no consistent data about the risk factors and prevention. Postoperative persistent chronic pain (POCP) is a serious health problem, disabling, undermining the quality of life of affected patients.
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