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Persistent postoperative pain: mechanisms and modulators.

Padma Gulur¹, Amanda Nelli

¹Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA.

Current Opinion in Anaesthesiology

|July 26, 2019

Summary

This summary is machine-generated.

Persistent postoperative pain (PPP) mechanisms are poorly understood but involve pain sensitization and altered spinal pathways. Neuroplastic changes and neuro-immune interactions may explain this transition from acute to chronic pain.

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Area of Science:

Neuroscience
Pain Research
Epidemiology

Background:

Persistent postoperative pain (PPP) is a significant clinical challenge.
Understanding the transition from acute to chronic pain is crucial for management.
Current knowledge of PPP mechanisms remains limited.

Purpose of the Study:

To review current understanding of PPP mechanisms.
To explore modulators influencing the acute to chronic pain transition.
To integrate basic science and epidemiological perspectives on PPP.

Main Methods:

Review of basic science research, including animal models.
Analysis of epidemiological data on pain transitions.
Synthesis of current hypotheses on PPP development.

Main Results:

Hypothesized mechanisms include nociceptive and neuropathic pain signaling.
Pain sensitization due to persistent noxious stimuli is implicated.
Alterations in spinal inhibitory pathways and descending modulation are suggested.

Conclusions:

Maladaptive neuroplastic changes driven by neurotrophic factors may underlie PPP.
Interactions between neurons and microglia are potential contributors.
Further research is needed to elucidate PPP mechanisms and identify therapeutic targets.