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Perioperative Hyperalgesia and Associated Clinical Factors

  • Other Pain (N Vadivelu and A Kaye, Section Editors)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Pain has an important evolutionary role because it serves as an essential warning device to damaging stimuli. The perioperative setting is a unique environment where clinicians must accurately diagnose and address the source of pain. Modern-day perioperative pain control continues to be unsatisfactory. Nearly half of all surgical patients have moderate to severe pain postoperatively, and 24% experience inadequate pain relief. Furthermore, over half of the patients develop chronic pain after thoracotomies, mastectomies, and limb amputation surgeries. Hyperalgesia in the perioperative setting is an important and under-recognized source of morbidity during the perioperative course.

Recent Findings

Key sources of perioperative hyperalgesia include nociceptive-induced pain with surgical trauma, opioid-induced hyperalgesia, and inadequate control of pain in the preoperative setting. Research also hints that inhaled anesthetics may also play a role in the development of perioperative hyperalgesia. Despite new evidence, hyperalgesia remains difficult to diagnose and treat.

Summary

In our manuscript, we aim to help clinicians develop strategies to define, understand, diagnose, and treat perioperative hyperalgesia. Common mechanisms of perioperative hyperalgesia are delineated in an organized fashion with clinicians as the target audience.

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Authors and Affiliations

  1. Department of Anesthesia, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA

    Obaid S. Malik

  2. Department of Anesthesiology and Pain Medicine, LSU Health Science Center, Louisiana State University School of Medicine, 1542 Tulane Avenue, Room 659, New Orleans, LA, 70112, USA

    Alan D. Kaye

  3. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA

    Richard D. Urman

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  1. Obaid S. Malik
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Correspondence to Richard D. Urman.

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Obaid S. Malik and Alan D. Kaye declare that they have no conflict of interest.

Richard D. Urman has received research funding from Mallinckrodt and Premier Pharmaceuticals.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Other Pain

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Malik, O.S., Kaye, A.D. & Urman, R.D. Perioperative Hyperalgesia and Associated Clinical Factors. Curr Pain Headache Rep 21, 4 (2017). https://doi.org/10.1007/s11916-017-0602-3

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