Chronic Pain After Surgery

Spencer S. Liu, M.D.
Clinical Professor of Anesthesiology
Director of Acute Pain Service
Department of Anesthesia
Hospital for Special Surgery and the Weill College of Medicine
at Cornell University
New York, NY

Introduction

Previous surveys continue to report that pain after surgery is the primary concern of patients and is of greater concern than the surgical outcome.1  Unfortunately, this concern remains justified, as it has been well established that acute postoperative pain remains under-treated.   Despite enhanced awareness, publication of guidelines for postoperative analgesia, and regulatory requirements for postoperative analgesia, 47% of patients still report moderate pain after surgery, and 31% report severe or extreme pain.1  Given the interest in the acute pain following surgery, it is a natural extension that development of chronic post surgical pain (CPSP) has become of increasing interest. 

CPSP has now been firmly established for several surgical procedures, but many aspects of this condition are ill defined which hampers diagnosis, prevention, and treatment.  CPSP has been defined as pain developing after a surgical procedure, lasting for at least 2 months in duration, and after exclusion of other current or pre-existing problems.2 

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