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The expanding role of chronic pain interventions in multimodal perioperative pain management: a narrative review

Ying Ye, Rodney A. Gabriel, Edward R. Mariano

2021Postgraduate Medicine18 citationsDOI

Abstract

Surgery is a risk factor for chronic pain and long-term opioid use. As perioperative pain management continues to evolve, treatment modalities traditionally used for chronic pain therapy may provide additional benefit to patients undergoing surgery. Interventions such as radiofrequency ablation, cryoneurolysis, and neuromodulation may potentially be used in conjunction with acute pain procedures such as nerve blocks and multimodal analgesia. Pharmacological agents associated with chronic pain medicine, including gabapentinoids, ketamine, and selective serotonin reuptake inhibitors, may be useful adjuncts in perioperative pain management when indicated. There may also be a role for acupuncture, music therapy, and other integrative medicine therapies. A transitional pain service can help coordinate outpatient care with inpatient perioperative pain management and promote a more personalized and comprehensive approach that can improve postoperative outcomes.

Topics & Concepts

MedicineChronic painKetaminePerioperativePsychological interventionModalitiesAcupunctureMultimodal therapyIntensive care medicinePhysical therapyAnesthesiaAlternative medicineSurgeryPsychiatrySocial scienceSociologyPathologyAnesthesia and Pain ManagementPain Management and Opioid UsePain Management and Placebo Effect