Prevention of chronic postoperative pain

Cellular, molecular, and clinical insights for mechanism-based treatment approaches

Ronald Deumens* (Corresponding Author), Arnaud Steyaert, Patrice Forget, Michael Schubert, Patricia Lavand'homme, Emmanuel Hermans, Marc De Kock

*Corresponding author for this work

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Nearly every surgery can elicit a rather therapy-resistant chronic postoperative pain. Preventive medicine is therefore anticipated with hopeful eyes, but requires a better understanding of the neurobiological mechanisms underlying the transition from acute to chronic pain. Spinal mechanisms of pain amplification are regarded as fundamental to pain chronification, but these mechanisms on their own are not at all likely to be sufficient. Indeed, not every surgical patient develops chronic postoperative pain. Progress in our neurobiological understanding of postoperative pain includes scientific discoveries of ‘vulnerability factors’, which substantially impact on the spinal cord, augmenting pain amplification mechanisms, perhaps to levels of no-return. In this review we elaborate on spinal pain amplification mechanisms in relation to pain chronification and the impact of vulnerability factors hereon. Moreover, these insights are incorporated within a clinical frame of treatment approaches currently used in surgical settings. As such, this review provides an integrated overview of mechanism-based treatment approaches in prevention of chronic postoperative pain.
Original languageEnglish
Pages (from-to)1-37
Number of pages37
JournalProgress in Neurobiology
Volume104
Early online date11 Feb 2013
DOIs
Publication statusPublished - May 2013

Fingerprint

Postoperative Pain
Chronic Pain
Pain
Therapeutics
Preventive Medicine
Spinal Cord

Keywords

  • Surgery
  • Sensitization
  • Inflammation
  • Glia

Cite this

Prevention of chronic postoperative pain : Cellular, molecular, and clinical insights for mechanism-based treatment approaches. / Deumens, Ronald (Corresponding Author); Steyaert, Arnaud; Forget, Patrice; Schubert, Michael; Lavand'homme, Patricia; Hermans, Emmanuel; De Kock, Marc.

In: Progress in Neurobiology, Vol. 104, 05.2013, p. 1-37.

Research output: Contribution to journalArticle

Deumens, Ronald ; Steyaert, Arnaud ; Forget, Patrice ; Schubert, Michael ; Lavand'homme, Patricia ; Hermans, Emmanuel ; De Kock, Marc. / Prevention of chronic postoperative pain : Cellular, molecular, and clinical insights for mechanism-based treatment approaches. In: Progress in Neurobiology. 2013 ; Vol. 104. pp. 1-37.
@article{75e239b1acac4f89a2516248ccbf8db1,
title = "Prevention of chronic postoperative pain: Cellular, molecular, and clinical insights for mechanism-based treatment approaches",
abstract = "Nearly every surgery can elicit a rather therapy-resistant chronic postoperative pain. Preventive medicine is therefore anticipated with hopeful eyes, but requires a better understanding of the neurobiological mechanisms underlying the transition from acute to chronic pain. Spinal mechanisms of pain amplification are regarded as fundamental to pain chronification, but these mechanisms on their own are not at all likely to be sufficient. Indeed, not every surgical patient develops chronic postoperative pain. Progress in our neurobiological understanding of postoperative pain includes scientific discoveries of ‘vulnerability factors’, which substantially impact on the spinal cord, augmenting pain amplification mechanisms, perhaps to levels of no-return. In this review we elaborate on spinal pain amplification mechanisms in relation to pain chronification and the impact of vulnerability factors hereon. Moreover, these insights are incorporated within a clinical frame of treatment approaches currently used in surgical settings. As such, this review provides an integrated overview of mechanism-based treatment approaches in prevention of chronic postoperative pain.",
keywords = "Surgery, Sensitization, Inflammation, Glia",
author = "Ronald Deumens and Arnaud Steyaert and Patrice Forget and Michael Schubert and Patricia Lavand'homme and Emmanuel Hermans and {De Kock}, Marc",
note = "Acknowledgements This work was financially supported by an FSR Incoming Post-doctoral Fellowship of the Acad{\'e}mie universitaire ‘Louvain’, co-funded by the Marie Curie Actions of the European Commission (2012, to RD), and by a grant of Ministry of Scientific Policy (Belgium, ARC 10/15-026).",
year = "2013",
month = "5",
doi = "10.1016/j.pneurobio.2013.01.002",
language = "English",
volume = "104",
pages = "1--37",
journal = "Progress in Neurobiology",
issn = "0301-0082",
publisher = "Elsevier Limited",

}

TY - JOUR

T1 - Prevention of chronic postoperative pain

T2 - Cellular, molecular, and clinical insights for mechanism-based treatment approaches

AU - Deumens, Ronald

AU - Steyaert, Arnaud

AU - Forget, Patrice

AU - Schubert, Michael

AU - Lavand'homme, Patricia

AU - Hermans, Emmanuel

AU - De Kock, Marc

N1 - Acknowledgements This work was financially supported by an FSR Incoming Post-doctoral Fellowship of the Académie universitaire ‘Louvain’, co-funded by the Marie Curie Actions of the European Commission (2012, to RD), and by a grant of Ministry of Scientific Policy (Belgium, ARC 10/15-026).

PY - 2013/5

Y1 - 2013/5

N2 - Nearly every surgery can elicit a rather therapy-resistant chronic postoperative pain. Preventive medicine is therefore anticipated with hopeful eyes, but requires a better understanding of the neurobiological mechanisms underlying the transition from acute to chronic pain. Spinal mechanisms of pain amplification are regarded as fundamental to pain chronification, but these mechanisms on their own are not at all likely to be sufficient. Indeed, not every surgical patient develops chronic postoperative pain. Progress in our neurobiological understanding of postoperative pain includes scientific discoveries of ‘vulnerability factors’, which substantially impact on the spinal cord, augmenting pain amplification mechanisms, perhaps to levels of no-return. In this review we elaborate on spinal pain amplification mechanisms in relation to pain chronification and the impact of vulnerability factors hereon. Moreover, these insights are incorporated within a clinical frame of treatment approaches currently used in surgical settings. As such, this review provides an integrated overview of mechanism-based treatment approaches in prevention of chronic postoperative pain.

AB - Nearly every surgery can elicit a rather therapy-resistant chronic postoperative pain. Preventive medicine is therefore anticipated with hopeful eyes, but requires a better understanding of the neurobiological mechanisms underlying the transition from acute to chronic pain. Spinal mechanisms of pain amplification are regarded as fundamental to pain chronification, but these mechanisms on their own are not at all likely to be sufficient. Indeed, not every surgical patient develops chronic postoperative pain. Progress in our neurobiological understanding of postoperative pain includes scientific discoveries of ‘vulnerability factors’, which substantially impact on the spinal cord, augmenting pain amplification mechanisms, perhaps to levels of no-return. In this review we elaborate on spinal pain amplification mechanisms in relation to pain chronification and the impact of vulnerability factors hereon. Moreover, these insights are incorporated within a clinical frame of treatment approaches currently used in surgical settings. As such, this review provides an integrated overview of mechanism-based treatment approaches in prevention of chronic postoperative pain.

KW - Surgery

KW - Sensitization

KW - Inflammation

KW - Glia

UR - http://www.scopus.com/inward/record.url?eid=2-s2.0-84876802980&partnerID=MN8TOARS

U2 - 10.1016/j.pneurobio.2013.01.002

DO - 10.1016/j.pneurobio.2013.01.002

M3 - Article

VL - 104

SP - 1

EP - 37

JO - Progress in Neurobiology

JF - Progress in Neurobiology

SN - 0301-0082

ER -