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Preemptive Analgesia, Regional Anesthesia, and Prevention of Chronic Postoperative Pain

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Essentials of Regional Anesthesia

Abstract

Preemptive analgesia is focused on both the prevention and treatment of postoperative pain. There are several factors at play related to postoperative pain and the individual patient. Furthermore, sensitization is an important aspect to consider when determining an appropriate analgesic plan for patients. Similarly, exposure to noxious stimuli for prolonged periods or of high frequency in the periphery can lead to changes in the central nervous system pain processing centers, which can affect the appropriate analgesic plan for patients. Pain can be controlled in several phases of perioperative care including pre-, peri-, and postoperative periods, and many agents can be used as preemptive analgesic treatments such as NSAIDs, local anesthetics, opioids, and NMDA receptor antagonists. Local wound infiltration is being used in conjunction with nerve blocks and is becoming an efficient method of postoperative pain control. Regional anesthesia is also continuing to grow and is used for a wide variety of procedures in the treatment of chronic pain. Several complex pain syndromes are discussed in this chapter, as well as the diagnostic criteria and how to treat them. Overall, the value of comprehensive pain control for surgical patients should not be underestimated and is likely to be best addressed with a multimodal, patient-specific approach.

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Authors and Affiliations

  1. Department of Anesthesiology, Louisiana State University—New Orleans, New Orleans, LA, USA

    Erik M. Helander M.B.B.S.

  2. Department of Anesthesiology, University Health, Shreveport, LA, USA

    Jonathan P. Eskander M.D., M.B.A.

  3. Department of Anesthesia, Louisiana State University Health Sciences Center, New Orleans, LA, USA

    Christina L. Juneau B.Sc.

  4. Neuroscience, Medical College of Wisconsin, University of Minnesota, Wausau, WI, USA

    Matthew B. Novitch M.S.

  5. Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, MD, USA

    Amit Prabhakar M.D., M.S.

  6. School of Medicine, Louisiana State University Health Sciences Center—New Orleans, New Orleans, LA, USA

    Amy M. DeKerlegand B.S.

  7. Department of Anesthesiology, Louisiana State University Health Sciences Center—Shreveport, Shreveport, LA, USA

    Elyse M. Cornett Ph.D.

  8. Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, LA, USA

    Alan David Kaye M.D., Ph.D.

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  1. Erik M. Helander M.B.B.S.
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  3. Christina L. Juneau B.Sc.
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  5. Amit Prabhakar M.D., M.S.
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  6. Amy M. DeKerlegand B.S.
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  8. Alan David Kaye M.D., Ph.D.
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Correspondence to Erik M. Helander M.B.B.S. .

Editor information

Editors and Affiliations

  1. Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, Louisiana, USA

    Alan David Kaye

  2. Department of Anesthesiology Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA

    Richard D. Urman

  3. Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut, USA

    Nalini Vadivelu

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Helander, E.M. et al. (2018). Preemptive Analgesia, Regional Anesthesia, and Prevention of Chronic Postoperative Pain. In: Kaye, A., Urman, R., Vadivelu, N. (eds) Essentials of Regional Anesthesia. Springer, Cham. https://doi.org/10.1007/978-3-319-74838-2_23

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  • DOI: https://doi.org/10.1007/978-3-319-74838-2_23

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