Pain Management Centre, National Hospital for Neurology and Neurosurgery, London, UK.
Anaesthesia. 2016 Jan;71 Suppl 1:64-71. doi: 10.1111/anae.13306.
Chronic postoperative pain is common. Nerve injury and inflammation promote chronic pain, the risk of which is influenced by patient factors, including psychological characteristics. Interventional trials to prevent chronic postoperative pain have been underpowered with inadequate patient follow-up. Ketamine may reduce chronic postoperative pain, although the optimum treatment duration and dose for different operations have yet to be identified. The evidence for gabapentin and pregabalin is encouraging but weak; further work is needed before these drugs can be recommended for the prevention of chronic pain. Regional techniques reduce the rates of chronic pain after thoracotomy and breast cancer surgery. Nerve-sparing surgical techniques may be of benefit, although nerve injury is not necessary or sufficient for chronic pain to develop.
慢性术后疼痛很常见。神经损伤和炎症会促进慢性疼痛，其风险受到患者因素的影响，包括心理特征。预防慢性术后疼痛的介入性试验因患者随访不足而效力不足。氯胺酮可能会减轻慢性术后疼痛，尽管不同手术的最佳治疗持续时间和剂量尚未确定。加巴喷丁和普瑞巴林的证据令人鼓舞但很微弱；在推荐这些药物预防慢性疼痛之前，还需要做更多的工作。区域技术可降低开胸术和乳腺癌手术后慢性疼痛的发生率。神经保护手术技术可能有益，尽管神经损伤不是慢性疼痛发展的必要或充分条件。
