Mark I Johnson
The safety of surgical techniques has been identified as a publichealth concern. Surgery causes tissue damage to somatic, visceral and neural structures resulting in peripheral and central sensitisation of the nociceptive system and pain that may be nociceptive and/or neuropathic in origin. Acute post-surgical pain may be localised around the incision but may also spread because of soft tissue injury from surgical trauma and retraction. Pain may be at rest and/or on movement and paroxysmal without clear evoking stimuli. Pain may be accompanied by hyperalgesia, allodynia, hypaesthesia and dysaesthesia. Neuroplastic changes in the brain may contribute to the development of chronic post-surgical pain. The unique and complex pathophysiology of surgical pain means that pain management is challenging with a variety of pharmacological and non-pharmacological techniques available for use. However, inadequate management of post-surgical pain remains a problem and is known to increase the risk of developing moderate-to-severe acute and chronic post-surgical pain.
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