Chronic pain after surgery: pathophysiology, risk factors and prevention

Reddi, D.; Curran, Natasha

doi:10.1136/postgradmedj-2013-132215

Cited by 175 publications

(148 citation statements)

References 50 publications

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“…Maka, kerusakan saraf intraoperatif harus diminimalkan, guna mencegah terjadinya nyeri kronis. 16 Salah satu teknik operasi yang dapat diterapkan untuk mengurangi nyeri kronis pasca operasi adalah teknik laparoskopi. 17 Pengalaman dari seorang ahli bedah, yaitu dalam teknik operasi dalam meminimalisir kerusakan saraf dan lebih tingginya tingkat unit operasi mempengaruhi terjadinya nyeri kronis.…”

Section: Operasi Sebagai Faktor Risiko Dan Pencegahannyaunclassified

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Pencegahan nyeri kronis pasca operasi

Suseno¹

2017

MKA

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AbstrakNyeri kronis pasca operasi merupakan salah satu nyeri kronis yang paling sering terjadi. Nyeri kronis tersebut memberikan dampak negatif bagi kesehatan mental, kualitas hidup, dan perekonomian masyarakat. Penyebab dari nyeri kronis pasca operasi belum diketahui secara pasti, tetapi diduga bahwa perubahan plastisitas pada sistem saraf pusat berkontribusi dalam terjadinya nyeri kronis. Pencegahan terjadinya nyeri kronis pasca operasi dapat ditempuh dengan beberapa cara yang bertujuan untuk meminimalisir terjadinya sensitisasi pusat di sistem saraf pusat yang mengakibatkan nyeri kronis. Cara yang ditempuh dalam pencegahan nyeri kronis pasca operasi dengan mempertimbangkan faktor psikososial, pemilihan teknik operasi yang dapat meminimalisir kerusakan saraf perifer, pemilihan teknik anestesi, dan penggunaan preemptive analgesia. Dalam penulisan ini bertujuan untuk membahas mengenai patofisiologi nyeri kronis pasca operasi, cara yang ditempuh untuk mencegah terjadinya nyeri kronis pasca operasi, dan perlunya mempertimbangkan faktor psikososial selain intervensi farmakologis sebagai bagian dari pendekatan holistik dari penatalaksanaan perioperatif untuk mencegah nyeri kronis pasca operasi. Kata kunci: pencegahan; nyeri kronis; pasca operasi Abstract Chronic pain after surgery is one of the most common chronic pain. This type of pain has negative impact on mental health, quality of life, and the economy. The cause of chronic pain after surgery is not known for certain, but it is thought that the changes in plasticity in

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Section: Operasi Sebagai Faktor Risiko Dan Pencegahannyaunclassified

“…16 tulang belakang ke arah belakang dapat menyebabkan terjadinya patah tulang dan kelumpuhan. Pada keadaan tersebut, timbul suatu antisipasi yang seharusnya merupakan suatu respons yang baik untuk menghindari hal yang buruk, akan tetapi kebiasaan berpikir negatif menyebabkan antisipasi tersebut menjadi suatu hal yang salah.…”

Section: Faktor Psikososialunclassified

Pencegahan nyeri kronis pasca operasi

Suseno¹

2017

MKA

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“…It may possibly prevent the barrage of nociceptive inputs into the dorsal horn preventing central sensitization by minimizing the transmission of signals to or within the spinal cord. Peripheral nerve blocks and would infiltrations interrupt impulses in peripheral nerves whereas Subarachanoid block and edpiural block techniques act on the nerve roots [1]. A Cochrane review done among 23 RCTs and data pooled from 250 patients in three trials, found that epidural anesthesia for thoracotomy to be beneficial in reducing the risk of chronic pain at 6 months [4].…”

Section: Regional Anesthesia and Analgesic Consideration Affecting Cpopmentioning

confidence: 99%

“…There are several risk factors which result in Chronic postoperative pain including preoperative, intraoperative and postoperative [1]. In case of abdominal surgeries, pain is due to incision in abdominal or visceral wall.…”

Section: Introductionmentioning

confidence: 99%

“…A survey done about on 5000 patients found that 34.2% of patients visiting clinic have degenerative diseases and the second largest 22.5% of patients have chronic pain following the surgical procedure [1]. International Association for the study of pain (IASP) defines chronic pain as pain without apparent biological value that has persisted beyond the normal tissue; healing time is usually considered 3 months, however when it comes to CPOP, the working definition as mentioned in Table 1 written by Marcae and Davies, which is adopted and still frequently used [2].…”

Section: Introductionmentioning

confidence: 99%

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Effect of Transverse Abdominis Plane Block on Chronic Post-Operative Pain—A Review

Lamichhane¹,

Yang²,

Ma³

2017

OJAnes

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Chronic post-operative pain is a recognized adverse consequence of surgery; managing and preventing it are always a better choice. Proper choice of Anesthetic technique, use of combined anesthesia and pre-emptive analgesia may prevent and decrease the incidence of chronic post-operative pain. Transverse abdominis plane block (TAP Block) is a regional anesthesia technique following abdominal surgeries which involve injection of a large amount of local anesthetics in TAP, an anatomical space between the internal oblique and transverse abdominis muscle. The aim of this review is to show the effect and uses of TAP block as a combined anesthesia and multimodal analgesia in preventing chronic post-operative pain.

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Longitudinal Examination of Frequency of and Risk Factors for Severe Dry Eye Symptoms in US Veterans

et al. 2017

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IMPORTANCE Dry eye syndrome is a common condition that affects millions of individuals. Many cross-sectional studies have evaluated risk factors for dry eye severity, but few have assessed risk factors or symptom progression over time. OBJECTIVES To assess symptom progression in dry eye syndrome and determine risk factors associated with severe symptoms at 1 year. DESIGN, SETTING, AND PARTICIPANTS A longitudinal study was conducted from October 1, 2013, to April 30, 2015, among patients at the Miami Veterans Affairs Hospital with a wide variety of dry eye symptoms and signs (ranging from none to severe). MAIN OUTCOMES AND MEASURES Change in dry eye symptom severity during 1 year, as assessed by responses to dry eye symptom questionnaires administered at the initial visit and 1 year later, as well as baseline risk factor analysis for severe dry eye symptoms at 1 year, defined as a Dry Eye Questionnaire 5 score of 12 or more. RESULTS Of the 120 patients (mean [SD] age, 64 [11] years; 109 male and 11 female), 26 of 58 (44.8%) with either no symptoms or mild or moderate symptoms at baseline progressed to more severe symptoms at 1 year, while 46 of 62 patients (74.2%) with severe symptoms at baseline reported that severe symptoms persisted at 1 year. Baseline ocular risk factors for severe dry eye symptoms at 1 year included more severe dry eye symptoms, ocular pain, and neuropathic pain-like ocular symptoms. Nonocular risk factors included sleep disturbances (eg, sleep apnea and insomnia), mental health status (eg, posttraumatic stress disorder and depression), nonocular pain, and medications (eg, anxiolytics and analgesics). In a multivariable analysis, the most significant risk factors were sleep apnea (odds ratio [OR], 3.80; 95% CI, 1.00-14.49; P = .05), Dry Eye Questionnaire 5 score (OR, 1.15; 95% CI, 1.02-1.30; P = .02), and posttraumatic stress disorder score (OR, 1.04; 95% CI, 1.01-1.08; P = .02). CONCLUSIONS AND RELEVANCE Patients with severe dry eye symptoms and ocular pain at baseline were more likely to have persistent severe dry eye symptoms on 1-year follow-up. Furthermore, nonocular risk factors that have been associated with dry eye cross-sectionally, such as psychiatric comorbidities and nonocular pain, were also associated with severe dry eye symptoms at 1 year. Although this cohort was limited to US veterans, which may not be generalizable to other populations, our results suggest that pain perception and severity are important when evaluating and managing dry eye.

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Chronic pain after surgery: pathophysiology, risk factors and prevention

Cited by 175 publications

References 50 publications

Pencegahan nyeri kronis pasca operasi

Pencegahan nyeri kronis pasca operasi

Effect of Transverse Abdominis Plane Block on Chronic Post-Operative Pain—A Review

Longitudinal Examination of Frequency of and Risk Factors for Severe Dry Eye Symptoms in US Veterans

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