Regional anesthesia and analgesia: prevention of chronic pain

Chronic pain after surgery is an area that has been neglected. Though limited in clinical trials, there is reasonable evidence that there are specific risk factors for developing chronic pain after surgery. These patients should be identified preoperatively and followed up very closely by the anesthesiologist during the postoperative period so as to prevent the development of chronic pain. Regional anesthesia and analgesia should be utilized when possible in these surgical cases, and a multimodal approach to controlling the perioperative pain with the goal to prevent spinal cord sensitization should prevent chronic pain and improve outcomes for postsurgical patients. Severe acute postoperative pain has been demonstrated in several studies to be one of the leading predictors for the development of chronic pain after surgery. A collaborative team approach between the surgeons and the anesthesiologist should focus during the postoperative period to utilizing regional analgesia with the goal of decreasing the incidence of chronic pain from surgery.