Late chronische pijn na een operatie voorkomen door goede perioperatieve pijnbestrijding

Chronic pain after surgery is a substantial medical and societal problem, but is often not recognised as such.

Several risk factors for postoperative chronic pain have been identified, including preoperative pain, severe postoperative pain and young age.

In recent decades, our understanding of pain mechanisms has increased greatly, but the effectiveness of the treatment of acute and chronic pain has lagged behind.

The key for the development of prevention and treatment strategies for postoperative chronic pain is to study the mechanisms of pain, with distinction between patient and surgery-related factors.

Postoperative chronic pain results from sensitisation of the central nervous system, causing hyperalgesia. The degree of central sensitisation depends on the balance between central excitatory and inhibitory processes.

Persisting postoperative hyperalgesia and nerve damage during surgery are probably the most important factors in the development of chronic pain.

There is evidence that some instances of postoperative chronic pain may be prevented by improving perioperative pain and hyperalgesia treatment.