Gómez Maria, Izquierdo Cesar E, Mayoral Rojals Victor, Pergolizzi Joseph, Plancarte Sanchez Ricardo, Paladini Antonella, Varrassi Giustino
Federación Latinoamericana de Asociaciones para el Estudio del Dolor, Hospital Universitario Nacional de Colombia, Bogotá, COL.
Pain Management and Palliative Care, Instituto Nacional de Salud del Nino, San Borja, PER.
Cureus. 2022 Apr 2;14(4):e23763. doi: 10.7759/cureus.23763. eCollection 2022 Apr.
Chronic postoperative pain (CPOP) is prevalent, with particularly high rates in breast surgery, thoracotomy, and amputation. As the world emerges from the coronavirus disease 2019 (COVID-19) lockdowns, it is expected that there will be an increase in surgical procedures, elevating the importance of preventing CPOP in the coming years. Risk factors are emerging to better stratify patients at high risk for CPOP. Perioperative analgesia plays an important role in managing acute postoperative pain and in some cases may limit its transition to CPOP. Acute postoperative pain is adaptive, normal, expected, and has a well-defined trajectory, while CPOP is maladaptive and, as a form of chronic pain, is challenging to treat. Good analgesia, early ambulation, and rehabilitation efforts may be helpful in preventing CPOP following certain surgeries. Enhanced Recovery After Surgery (ERAS) protocols present guidance to help promote recovery and prevent CPOP.
慢性术后疼痛（CPOP）很常见，在乳房手术、开胸手术和截肢手术中发生率尤其高。随着世界从2019冠状病毒病（COVID-19）封锁中解封，预计外科手术数量将会增加，这提升了未来几年预防CPOP的重要性。越来越多的风险因素有助于更好地对CPOP高危患者进行分层。围手术期镇痛在管理急性术后疼痛方面发挥着重要作用，在某些情况下可能会限制其转变为CPOP。急性术后疼痛是适应性的、正常的、预期的，并且有明确的病程，而CPOP是适应不良的，作为一种慢性疼痛形式，治疗起来具有挑战性。良好的镇痛、早期活动和康复措施可能有助于预防某些手术后的CPOP。术后加速康复（ERAS）方案提供了有助于促进康复和预防CPOP的指导。
