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Chronic Pain

  • Katherin PeperzakEmail author
  • Preetma Kooner
Chapter

Abstract

Patients with chronic pain are at risk for difficult to control postoperative pain. Preoperative evaluation with an emphasis on expectation management is key. In addition, a multimodal approach should be used throughout the patient’s perioperative course including opioid and non-opioid systemic pharmacotherapy, procedural interventions such as local infiltration, peripheral nerve block, and neuraxial blockade, as well as cognitive and physical nonpharmacologic modalities.

Keywords

Chronic pain Preoperative Perioperative Multimodal analgesia 

Notes

Acknowledgments

Dr. Christina Bockman, PharmD, Pharmacist, Department of Anesthesiology and Pain Medicine, University of Washington

References

  1. 1.
    Carroll IR, Angst MS, Clark JD. Management of perioperative pain in patients chronically consuming opioids. Reg Anesth Pain Med. 2004;29(6):576–91.CrossRefGoogle Scholar
  2. 2.
    Chapman CR, Davis J, Donaldson GW, Naylor J, Winchester D. Postoperative pain trajectories in chronic pain patients undergoing surgery: the effects of chronic opioid pharmacotherapy on acute pain. J Pain. 2011;12(12):1240–1246. Open image in new windowGoogle Scholar
  3. 3.
    Chou R, et al. Management of postoperative pain: a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ committee on regional anesthesia, executive committee, and administrative council. J Pain. 2016;17(2):131–157. Open image in new windowGoogle Scholar
  4. 4.
    Tusek D, Church JM, Fazio VW. Guided imagery as a coping strategy for perioperative patients. AORN J. 1997;66(4):644–9.CrossRefGoogle Scholar
  5. 5.
    George JA, et al. The effect of intravenous opioid patient-controlled analgesia with and without background infusion on respiratory depression: a meta-analysis. J Opioid Manag. 2010;6(1):47–54.CrossRefGoogle Scholar
  6. 6.
    Chen MR, Dragoo JL. The effect of nonsteroidal anti-inflammatory drugs on tissue healing. Knee Surg Sports Traumatol Arthrosc. 2013;21(3):540–9.CrossRefGoogle Scholar
  7. 7.
    Marquez-Lara A, Hutchinson ID, Nuñez F, Smith TL, Miller AN. Nonsteroidal anti-inflammatory drugs and bone-healing: a systematic review of research quality. JBJS Rev. 2016;4(3).Google Scholar
  8. 8.
    Marret E, Rolin M, Beaussier M, Bonnet F. Meta-analysis of intravenous lidocaine and postoperative recovery after abdominal surgery. Br J Surg. 2008;95(11):1331–8.CrossRefGoogle Scholar
  9. 9.
    Bjordal JM, Johnson MI, Ljunggreen AE. Transcutaneous electrical nerve stimulation (TENS) can reduce postoperative analgesic consumption. A meta-analysis with assessment of optimal treatment parameters for postoperative pain. Eur J Pain (London, England). 2003;7(2):181–8.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Anesthesiology and Pain MedicineUniversity of WashingtonSeattleUSA

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