Chronic Post Surgical Pain (CPSP)
Introduction
Chronic postoperative pain is a poorly recognized, yet a potentially devastating outcome from an otherwise successful surgical procedure. The incidence is increasing with increasing number of surgeries. Dr. G. Ram Mohan is the best doctor for chronic post-operative pain in Himayatnagar at best chronic pain relief center in Hyderabad.
What are the diagnostic criteria for CPSP?
- The pain should have developed after a surgical procedure
- The pain should be of at least 2 months’ duration.
- Other causes for the pain should be excluded, e.g. continuing malignancy (after surgery for cancer) or chronic infection.
In particular, the possibility that the pain is continuing from a pre-existing problem should be explored and exclusion attempted.
Who are at risk for CPSP?
Risk of developing CPSP depends on
- Type of surgery
- Amputation
- Cardiac surgery
- Thoracic surgery
- Breast surgery
- Inguinal hernia surgery
- Total Knee replacement
- Severe pain before surgery
- Psychological factors (e.g. anxiety, depression, and catastrophizing)
- Female gender and younger age)
- Surgical factors (e.g. open surgery and long duration surgeries)
- Severe untreated pain after surgery
What are the probable mechanisms underlying CPSP?
Damage to major nerves during surgery is an important causal factor in most cases of CPOP; however, not all patients who have nerves injured go on to develop chronic pain, and pain can occur in the absence of known nerve sectioning.
What is the Post-surgical pain management in Himayatnagar?
- Conservative management
- TENS
- Pharmacological management
- Gabapentin, Pregabalin
- Tricyclic antidepressants (amitryptiline, nortryptiline)
- Selective serotonin noradrenergic reuptake inhibitors (Duloxetine)
- Interventional Pain Management
- Specific Nerve blocks / radiofrequency ablation
- Ilio-inguinal & ilio-hypogastric nerve blocks, genital branch of genito-femoral nerve for CPSP after hernia repair
- Intercosto-brachial and pectoral nerve blocks for CPOP after breast surgery/ mastectomy
- Intercostal blocks for CPSP after thoracic / cardiac surgery
- Rectus sheath and TAP blocks for CPSP after abdominal surgery, caesarean sections, hysterectomy
