Postoperative pain--clinical implications of basic research.
Postoperative incisional pain is a unique and common form of acute pain. Although ample evidence indicates that an efficeous postoperative pain treatment reduces patient morbidity and patient outcome, recent studies demonstrate that about 50-70% of patients experience moderate to severe pain after surgery indicating that postoperative pain remains poorly treated. Perhaps important reasons for this quandary are distinct mechanisms of incisional nociception compared to other pain conditions limiting our regimen to drugs designed for other clinical pain problems. Another reason might be the lack of an in depth knowledge about the pathophysiology and neuropharmacology of postoperative pain. Basic research offers important insights in the mechanisms of postsurgical incisional pain and the translation of experimental results into clinical practice will have important implications on the improvement of new multimodal treatment regimens based postoperative pain mechanisms. In the present review, recent developments in experimental postsurgical incisional pain research will be described and their possible relevance for clinical practice discussed.
Pogatzki-Zahn
Esther M
EM
Department of Anesthesiology and Intensive Care Medicine, University of Muenster, Albert Schweitzer Str. 33, 48149 Muenster, Germany. pogatzki@anit.uni-muenster.de
Zahn
Peter K
PK
Brennan
Timothy J
TJ
D000588:Amines / Q000627:therapeutic use; D000698:Analgesia; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D000077206:Gabapentin; D006801:Humans; D006930:Hyperalgesia / Q000188:drug therapy; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D000069583:Pregabalin; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives / Q000627:therapeutic use
D000588:Amines; D003509:Cyclohexanecarboxylic Acids; D018691:Excitatory Amino Acid Antagonists; D016194:Receptors, N-Methyl-D-Aspartate; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin