Chronic Pain Due to Postsurgical Intra-abdominal Adhesions: Therapeutic Options

  • Jose De Andres
  • Luciano Perotti
  • Stefano Palmisani
  • Vicente Luis Villanueva Perez
  • Juan Marcos Asensio-Samper
  • Gustavo Fabregat


Intra-abdominal adhesions are an important source of chronic pelvic pain. Thus, every physician should be familiar with pathogenesis of pain from adhesions, sources of referred pain, and the methods by which they can be prevented and treated.

The tests appear to have the greatest likelihood of identifying a visceral source of pain compared to somatic sources of abdominal pain.

Conventional pharmacologic therapy, sympathetic blocks, and radiofrequency application are important tool for the treatment of chronic visceral pain, but unfortunately they offer only a transient pain relief. Minimally, invasive pain interventions are very useful, but their correct choice must be based in the correct selection of the patients on the basis of the result of tests defining taxonomy of pain.

Central and peripheral neuromodulation (spinal cord stimulation, peripheral nerve stimulation, and peripheral field stimulation) has a role in the treatment of neuropathic pain deriving from nerve entrapment or radiculopathy. Pulsed radiofrequency may provide pain relief in thoracic radicular pain and Intrathecal Drug Delivery is an effective tool to be considered when other therapeutic options fail to provide adequate pain relief.

More basic research into the mechanisms of adhesiogenesis is truly needed for developing useful preventing Strategies


Neuromodulation Spinal cord stimulation Peripheral nerve stimulation Peripheral field stimulation Intrathecal drug delivery Pulsed radiofrequency Chronic pain Postsurgical intra-abdominal adhesions Abdominal pain 


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Jose De Andres
    • 1
    • 2
  • Luciano Perotti
    • 3
  • Stefano Palmisani
    • 4
    • 5
  • Vicente Luis Villanueva Perez
    • 2
  • Juan Marcos Asensio-Samper
    • 2
  • Gustavo Fabregat
    • 2
  1. 1.Anesthesia Division, Department of SurgeryValencia School of MedicineValenciaSpain
  2. 2.Anesthesia Critical Care and Pain Management DepartmentGeneral University HospitalValenciaSpain
  3. 3.Department of Anesthesia and Intensive CareCivil Hospital of VigevanoVigevanoItaly
  4. 4.Guy’s and St Thomas’ HospitalLondonUK
  5. 5.Pain Management and Neuromodulation CentreLondonUK

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