Der Schmerz
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Pain after surgery, especially on the first postoperative day, results in longer hospital stays, increased complication rates and may also cause a higher risk of pain chronification. However, the expected intensity of pain is often misjudged and therefore not adequately treated. ⋯ The risk of postoperative pain can be reduced by optimal care structures. Since patients treated in optimal care structures had significantly lower pain scores on exercise and with respect to maximum pain, the investment in the optimization of such resources should be carefully planned. Special attention should be paid to postoperative pain management in women, especially in younger female patients.
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The acute phase of complex regional pain syndrome (CRPS) is pathophysiologically characterized by an activation of the immune system and its associated inflammatory response. During the course of CRPS, central nervous symptoms like mechanical hyperalgesia, loss of sensation, and body perception disorders develop. ⋯ A stage adapted, targeted treatment could improve the prognosis. Effective multidisciplinary treatment includes the following: pharmacotherapy with steroids, bisphosphonates, or dimethylsulfoxide cream (acute phase), and antineuropathic analgesics (all phases); physiotherapy and behavioral therapy for pain-related anxiety and avoidance of movement; and interventional treatment like spinal cord or dorsal root ganglion stimulation if noninvasive options failed.