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

  • Erik M. Helander
  • Jonathan P. Eskander
  • Christina L. Juneau
  • Matthew B. Novitch
  • Amit Prabhakar
  • Amy M. DeKerlegand
  • Elyse M. Cornett
  • Alan David Kaye


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.


Pain Pain management Preemptive analgesia Opioid NSAID Epidural Nerve block Multimodal Regional anesthesia Perioperative 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Erik M. Helander
    • 1
  • Jonathan P. Eskander
    • 2
  • Christina L. Juneau
    • 3
  • Matthew B. Novitch
    • 4
  • Amit Prabhakar
    • 5
  • Amy M. DeKerlegand
    • 6
  • Elyse M. Cornett
    • 7
  • Alan David Kaye
    • 8
  1. 1.Department of AnesthesiologyLouisiana State University—New OrleansNew OrleansUSA
  2. 2.Department of AnesthesiologyUniversity HealthShreveportUSA
  3. 3.Department of AnesthesiaLouisiana State University Health Sciences CenterNew OrleansUSA
  4. 4.Neuroscience, Medical College of WisconsinUniversity of MinnesotaWausauUSA
  5. 5.Anesthesiology and Critical Care MedicineJohns Hopkins HospitalBaltimoreUSA
  6. 6.School of MedicineLouisiana State University Health Sciences Center—New OrleansNew OrleansUSA
  7. 7.Department of AnesthesiologyLouisiana State University Health Sciences Center—ShreveportShreveportUSA
  8. 8.Department of AnesthesiologyLouisiana State University School of MedicineNew OrleansUSA

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