Surgeons need to be more aware of techniques to prevent postoperative pain

Surgeons need to be more aware of the ways to avoid nerve injury during operations to prevent patients experiencing long-term pain after surgery, state the authors of a Review in this week's issue of The Lancet.

Persistent post-operative pain occurs in around 10-15% of individuals after common operations, such as leg amputation and coronary bypass surgery. Nerve damage is probably the most important cause of long-term postsurgical pain, therefore, surgical techniques to avoid this should be applied wherever possible, write Henrik Kehlet (The Juliane Marie Centre, Copenhagen, Denmark) and colleagues in their Review. Techniques to avoid nerve injury include careful dissection, reduction of inflammatory responses, and use of minimally invasive surgical techniques state the authors.

Professor Kehlet concludes: "Postsurgical persistent pain is a major, largely unrecognised clinical problem, which is distressing and reduces the quality of life of patients. Iatrogenic neuropathic pain is probably the most common type of postsurgical persistent pain and, as such, surgical techniques that avoid nerve damage should be used wherever possible… The primary focus for prevention needs to be an increased awareness among surgeons of ways to avoid intraoperative nerve injury."

Contact: Professor Henrik Kehlet, Section for Surgical Pathophysiology 4074, The Juliane Marie Centre, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark. T) +45 3545 4074 henrik.kehlet@rh.dk

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