Articles: chronic-pain.
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Reg Anesth Pain Med · Feb 2025
ReviewChronic postsurgical pain and transitional pain services: a narrative review highlighting European perspectives.
Chronic postsurgical pain (CPSP) is a significant, often debilitating outcome of surgery, impacting patients' quality of life and placing a substantial burden on healthcare systems worldwide. CPSP (pain persisting for more than 3 months postsurgery) leads to both physical and psychological distress. Recognized as a distinct chronic pain entity in International Classification of Diseases, 11th Revision, CPSP enables better reporting and improved management strategies. Despite advancements in surgical care, CPSP remains prevalent, affecting 5%-85% of patients, with higher rates following thoracotomies, amputations, mastectomies and joint replacements. ⋯ Future research should focus on large-scale studies integrating various factors to facilitate CPSP prediction, refine prevention strategies and reduce its long-term impact.
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Reg Anesth Pain Med · Feb 2025
ReviewTen years of transitional pain service research and practice: where are we and where do we go from here?
Chronic postsurgical pain (CPSP) is a prevalent yet unintended consequence of surgery with substantial burdens to the individual and their family, the healthcare system, and society at large. The present article briefly reviews the evidence for transitional pain services (TPSs) that have arisen in an effort to prevent and mange CPSP and persistent opioid use, and provides an update on recent novel risk factors for CPSP. Available evidence from one randomized controlled trial (RCT) and three non-randomized cohort studies suggests that TPS treatment is associated with better opioid use outcomes, including fewer opioid tablets prescribed at discharge, better opioid weaning results, a lower incidence of new-onset chronic opioid use, and lower consumption of opioids even at later time points up to 1 year after surgery. ⋯ While these preliminary studies are generally positive, large-scale, RCTs are needed to provide a more definitive picture of whether TPSs are effective in reducing opioid consumption and improving pain and mental health outcomes in the short and long term. With the expansion of TPSs across North America and globally, perioperative care focused on reducing the transition to pain chronicity has the potential to help millions of patients. With additional evidence from well-controlled RCTs, TPSs are well poised to continue to evolve and strengthen the role of multidisciplinary care teams in the immediate postdischarge period and beyond.
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Pain catastrophizing is understood as a negative cognitive and emotional response to pain. Researchers, clinicians, advocates, and patients have reported stigmatizing effects of the term on patients when used clinically and in the media. This report describes the results of an international, observational, cross-sectional study investigation of clinician and researcher (professionals) perspectives on the term pain catastrophizing and whether new terminology is needed or desired. ⋯ Results highlight the continual controversy surrounding the term pain catastrophizing and the need for additional research and education to incorporate patient-centered approaches into clinical and public communications. Perspective: We present a content analysis of international clinician and researcher perspectives on the term pain catastrophizing. This investigation provides the largest depiction to date of the controversy surrounding pain catastrophizing and may guide future efforts to decrease stigma in patients with chronic pain and improve patient-clinician communication.