Unexplained pain after scheduled limb surgery - 29/01/20

Doi : 10.1016/j.otsr.2019.05.027

Anissa Belbachir ^a,^⁎ , Régis Fuzier ^b, David Biau ^c
^a Service d’anesthésie réanimation, UF Douleur, université Paris-Descartes, hôpital Cochin, Assistance publique–Hôpitaux de Paris, Paris, France
^b Département d’anesthésie, institut Claudius-Regaud, institut universitaire du cancer Toulouse-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
^c Inserm U1153, service de chirurgie Orthopédique, université Paris-Descartes, hôpital Cochin, Assistance publique–Hôpitaux de Paris, Paris, France

^⁎Corresponding author.

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Abstract

Orthopedic surgery can lead to pain that is poorly if at all explicable, both in the immediate postoperative period and at longer term, impairing the surgical result and necessitating a multidisciplinary approach of multimodal analgesia throughout the patient's care pathway.

Preoperatively, patients at high risk of postoperative pain need to be identified and referred to a pain specialist to optimize pain management.

Surgical and anesthesiological measures then need to be taken intraoperatively to limit the risk of pain.

Finally, and most importantly, when pain does occur postoperatively, the surgeon needs to be able to treat any obvious cause and then rapidly to call in a pain specialist to identify the underlying causes and treat them effectively.

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Keywords : Postoperative pain, Orthopedics, Multimodal analgesia, Neuropathic pain