The Role of Regional Anesthesia in the Development of Chronic Pain: a Review of Literature

Abstract

Purpose of Review The acute management of pain using regional anesthesia techniques may prevent the development of persistent postsurgical pain (PPP), ultimately improving patient outcomes and enhancing overall quality of life in postsurgical patients. The purpose of this review is to describe the current literature regarding the role of regional anesthesia techniques in the perioperative setting to address and prevent PPP. Recent Findings Data was collected and analyzed using results from randomized controlled studies stratified into categories based on different surgical subspecialties. Conclusions were drawn from each surgical category regarding the role of regional anesthesia and/or local analgesia in acute and chronic pain management on the long-term results seen in the studies analyzed. Summary Preoperative consultations and optimized perioperative analgesia using regional anesthesia and local analgesia play a fundamental role preventing and treating postoperative pain after many types of surgery by managing pain in the acute setting to mitigate the future development of PPP. Additional studies in different surgical subspecialties are needed to confirm the role regional anesthesia plays in chronic postsurgical pain (CPSP) prevention.

Severe Postoperative Pain in Total Knee Arthroplasty Patients: Risk Factors, Insights and Implications for Pain Management via a Digital Health Approach

“…The potential mechanisms underlying the observed reduction in chronic pain incidence involve the prevention of central sensitization and modulation of the inflammatory response. Regional anesthesia techniques, by targeting specific nerve pathways, may contribute to a more controlled perioperative pain environment, mitigating the neuroplastic changes associated with chronic pain development [37]. Furthermore, the attenuation of the inflammatory response during the early stages of recovery may have implications for long-term pain outcomes [38].…”

Avances en Técnicas De Anestesia Regional: Beneficios Y Consideraciones.

“…Una de las ventajas más destacadas de la anestesia regional es su capacidad para proporcionar un control eficaz del dolor postoperatorio (4). Al bloquear la transmisión de señales de dolor en el nivel periférico, las técnicas de anestesia regional pueden reducir significativamente la intensidad del dolor postoperatorio, mejorar la satisfacción del paciente y facilitar la rehabilitación temprana (10,11). Esta mayor comodidad para el paciente también puede traducirse en una disminución en el consumo de analgésicos opioides y en una reducción de los efectos secundarios asociados con su uso (12,13).…”

“…La realización segura y efectiva de técnicas de anestesia regional requiere un alto nivel de competencia y experiencia por parte del anestesiólogo a cargo. Es fundamental que el profesional esté debidamente entrenado en las técnicas específicas de anestesia regional que pretende emplear, así como en el manejo de posibles complicaciones y eventos adversos (11,13). La habilidad para realizar una evaluación precisa de la anatomía del paciente, seleccionar la técnica adecuada, y administrar la dosis correcta de anestésico local son aspectos críticos que deben ser dominados a través de una formación y práctica adecuadas.…”